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#8 – Check in and out lab cases

All lab cases must be on time! One of the worst feeling that all of us can have is when the client is seated in the operatory and the doctor enters and asks, “Where’s Mrs. Jones crown?” After a certain amount of scurrying around the assistant says (usually from a safe distance) “I’m sorry, doctor, but the case doesn’t seem to have returned from the lab yet!” Client is upset. Doctor is upset. Let’s keep this from happening! We can avoid this embarrassment by having an organized, timely, and well-managed system.

Timelines for our labs:

Complete Dentures from _________________
Wax Rim—2 days
Set up —5 days
Finish — 5 days

All Plastic Removable Partial Denture from _______________________
Less than 3 teeth & no clasps–3 days
More than 3 teeth – 4 days
Rush case 1day, 2 with wrought wire clasps

Crowns from ________________

Bridges from _____________________

1. At completion of preparation appointment, a lab slip is always prepared. (2 lab slips with a carbon copy in between them) Don’t ever escort the client to the front desk unless the return date has been filled in so the front desk can schedule the final seat for AFTER the lab case will be back. One copy of the prescriptions is placed in a lab pan, The second copy along with models, photos, and final impressions will be sent to the designated lab. Put the lab pan away. Check with the other assistants to find out how the lab cases are aged and make sure you put your new case in the proper location. One easy way to age lab cases is to keep the oldest on a top shelf and the newest cases on the lowest shelf. This is very important step in making sure that we are staying organized and keeping our patient’s cases on track. Always ask questions if you are not sure of the full set up of checking in and out lab cases. Don’t guess!

To create a lab slip in EagleSoft:

  1. Open the crown prep appointment (double click)
  2. Click on New lab cases (right side top)
  3. Select New case
  4. Click Laboratory and select the proper lab
  5. Click Lab Case Type – this is where you put in either PFM or All Porcelain crown
  6. Click shade – this is where you select the shade that was chosen at the prep appointment
  7. At the bottom, mark the tooth/teeth that were prepped
  8. Click ok and close
  9. Next, open the crown seat appointment (double click)
  10. Go back into the lab cases
  11. Click the little box on the left side of the name- make sure it is the right lab case for that tooth b/c some have several lab cases
  12. Click apply – now, on the side of the appointment it will show a lab flask or test tube icon that looks half full – which means the crown is not back from the lab

Sending lab cases out:

1. Wrap models, etc. with materials that are available in the lab. Paper towels or tissue paper are o.k. but not as a shock absorber.
2. Wrap models individually with bubble wrap.
3. Any bite registrations, extra teeth, shading pictures and other small (able to be lost) pieces should be placed in a plastic bag to avoid losing.
4. Wad up newspaper or paper towels on the sides
5. Make sure prescription is enclosed and is completely filled out, signed and dated.
6. Lightly shake the box to make sure everything is secure.
7. Securely tape the box shut.
8. Put on proper out going shelf in the lab by the vending machine
9. Note the client’s name on the lab calendar on the return date has been designated and which lab it was sent to.

Case returned :

When a case is returned from the lab, make sure it is well protected. If not, check (particularly if it includes a Whip mix articulator) to make sure there is no damage. Then have any assistant who is in level 3 make sure it meets our standards. Remove all model materials from the box. Make sure that you hilight the patient’s name on the lab calendar. Please refer to lab calendar example sheet on the next page.

To document a lab case returned in EagleSoft:

  1. Double click on the flask/test tube icon in the crown seat appointment
  2. Highlight the correct lab case
  3. Click edit
  4. Select Close the lab case
  5. Now it will show the flask/test tube full – that means the case is back from the lab.

Every day

By 1:00 pm the regular package and express mail will have arrived. If a case has not returned by its due date call the lab! The 2 days between when the lab case is due and the client is appointed may be enough time for the lab to get the case to us and save the appointment. The day before a client is due check the lab area where tomorrow’s schedule is posted for the convenience of the tray set up person. Make sure all these cases are here and ready, also check lab calendar sheet to confirm that the case is here, etc.

1. Cases going to ______________ are to be picked up by someone from their staff.

2. Shipping Lab Cases through DHL or Fed Ex
a. Box up all materials safely. Make sure there is plenty of padding so as models don’t get broken. Include all bite registrations and lab slips.
b. Get the appropriate mailing label. Fill out our information. Some labs provide preprinted labels. All other labs you will need to look up addresses then call 1-800-DHL or 1-800-for UPS and ask for pick-up. They will give you a pick up number. Write this on DHL slip in corner. If you do not have a UPS or DHL pick up slip let them know and the driver will bring one.
c. After DHL picks up case they will leave a copy with a secretary. Secretary will give this copy to the doctor’s assistant then place this copy in the client’s lab, in case you need to notify lab. Make sure to mark on calendar in lab name and which lab and when case is expected back.

3. Crowns and bridges require extra check in procedures. Follow the checklist on the back of the lab sheet.
a. Make sure case is mounted on correct articulator (with a wet paper towel clean all plaster off before mounting never use a knife it can scratch the articulator)
b. Look at the contour of the crown, does it look like a tooth?
c. Place a piece of articulating paper between the casts and grind them around. Are the marks on the crown the same as on the yellow lab sheet?
d. Remove the die from the model. Check the fit of the crown under the microscope. All margins should be sealed against the die. Check the contacts on the model with floss.
e. Remove the crown from the die and make sure the red mark on the margin is present completely.
f. Check the shade. Compare the crown to the correct Vita Shade guide buttons as shown on the lab sheet diagram.
g. Make sure we have the Ident alloy label. This label guarantees the alloy content and goes on the back of the lab sheet. Call the lab if we haven’t received the label. Attach label to our copy of the client’s lab prescription.
1.Alloy content (3 choices)
a. high noble contains 40% gold and at least 60% noble
b. noble contains at 25% to 59% noble metals
c. predominatly base metal contains less than 25% noble metals
*Also note on lab sheet the initials of the lab tech*

4. Age lab cases
a. All lab pans are “aged” by putting the oldest case on the bottom row right side, filling that row, then moving to the top row on the right side. Once each day look at the 2 “oldest” lab pans and list the names of the cases you aren’t sure of.
b. Give this list to the secretaries to pull charts on these clients
c. Determine if the client is behind schedule treatment and if so bring the chart and lab plan to your huddle so the secretaries can call the client. Expect the secretaries to get back with you at the next huddle.
d. When the secretary reports on the call the dentist will decide how to handle the case and, make a note in the client’s chart. Date and notation about case (whether to box, keep, etc.) Also make a note on how much longer (if any) we will keep the model and the date the models will be thrown away.
e. Put the case in a green box with the patient’s name, date, and doctor on the front – place a paper on the inside stating when the patient was called and when the letter was sent and any other follow up.
f. After 3 years, pitch the box.

What Lab do we Send our Cases To?
Zirconia Crowns:
Full Gold Crown:
PVC:
Dentures:
All-plastic Partial:
Implant Crowns:
Metal Frame Partial :
Porcelain (Empress) Crown:
Emax:

______________________________ _______________

Signature (Chairside team leader) date