Paul Feuerstein, DMD, editor-in-chief of Dentistry Today, talks with Michael Verber, DMD, chairman and CEO of the Verber Dental Group, and Brett Mays, CDT, technology manager at VerTrue Dental Lab, to discuss hiring an in-house lab tech.
Q: What drove you to create this business model?
Dr. Verber: When the local dental lab that my father and I had used for decades sold to a larger corporation, we recognized a need for a patient-centered, team-driven lab component to our Dental Health System (DHS). Some of the more complex interdisciplinary implant and reconstructive cases in particular demand intimate involvement from our lab technicians.
Mr. Mays: The quality we are able to achieve can really only be made possible with the level of integration we have internally. Our lab technicians can be part of the entire process, from participating in consultations to final deliveries. We also have access to all the same records as the clinicians.
Q: Can you elaborate on the DHS model?
Dr. Verber: My partners and I realized that dentistry was a fragmented cottage industry that wasn’t fully serving patients in our community. When patients needed specialty care outside our offices, they could end up waiting months for appointments. Redundancies, communication difficulties, paperwork, clinical coordination, and excessive costs got in the way of delivering quality treatment. We did not like the DSO model, so we opted instead to commit to an employee-owned local footprint that brought together specialists and general dentists under one umbrella.
Mr. Mays: We can monitor the work that comes through and find opportunities for providing continuing education. We also have been working with Dr. John Cranham to coach our doctors through the Cranham Culp Digital Dentistry program.
Q: Who influenced the group and the lab specifically?
Dr. Verber: After graduating dental school, I looked forward to my first day working with my father, who was my mentor. Before I saw my first patient, Dad said “Go over to see Greg Thayer at Thayer Dental Lab. He will show you how to do good dentistry.” Dad understood the importance of the lab relationship. This was further reinforced by Dr. Peter Dawson during my time on the Dawson Academy faculty. Pete grew up in his father’s dental lab and stressed the importance of having control over the quality of lab work. He encouraged me to create the role of lab assistant in our office. Erickia Rynard, an extended-function dental assistant with decades of experience, was responsible for putting this idea into action. When we hired Brett a few years later, his formal training and digital expertise legitimized the operation, and things took off.
Mr. Mays: A great mix of people influenced me in the lab, from Greg Thayer, whom I worked for many years, and clinicians like Dr. Michael Scherer who work on the cutting edge of digital dentistry.
Q: What are the advantages and disadvantages to having an integrated lab?
Dr. Verber: We have a different perspective on quality. An independent lab needs to be focused on its unit costs and profit margins to survive. With our more holistic perspective we understand that if productivity in the lab leads to quality that doesn’t meet each clinician’s expectations, the cost is high.
While our clinicians demand quality from our lab, the opposite is also true. The lab has improved the quality of our work because we have empowered it to control the input. In a typical setting, the lab will sometimes be hesitant to critique or send back work. Our doctors and lab technicians are partners. For example, the lab techs have the authority to flag an impression and request a redo.
Mr. Mays: An independent lab has large startup costs. Although intraoral scanners, milling, and 3D printing have become much more affordable, they are still expensive, and there are annual fees to keep them up and running.
Q: What technology do you rely on in the lab?
Mr. Mays: 3Shape design software fuels the day-to-day workflow at VerTrue Dental Lab, as it is used to design almost every case, and iTero scanners are in every office, along with a CBCT system. Milling is done with a Roland DWX-52DCi. Another workhorse in our lab is 3D Systems’ NextDent 5100 3D printer, using almost all of the different NextDent resins for printing splints, temps, try-ins, models, and surgical guides.
Q: What do you think the future holds for dental laboratories?
Mr. Mays: The dental lab industry has changed since I started in 1997. The technologies in the dental lab used to be something only a large dental lab could invest in since they needed a huge volume to pay for themselves. Now, a 3D printer, which is almost the size of a toaster, can print a highly accurate splint in 20 minutes, benefitting the practice.
Dr. Verber: We are seeing a lot of consolidation as small dental laboratories close or get acquired. There will always be a market for production laboratories, but I think technology and remote work offer a lot of new opportunities. Dental offices and labs big and small will be able to bring in or outsource more pieces of the process to have more control of where and when they want it.
ABOUT THE SUBJECTS
Dr. Verber is the clinical director of the Verber Advanced Dental Institute and the CEO of the Verber Dental Group, a unique dental health system located in South Central Pennsylvania. He can be reached at dr.verber@verberdental.com.
Mr. Mays brings 24 years of dental technician experience to his current position and enjoys working with his innovative team at the Verber Dental Group.
He can be reached at bmays@vertruedental.com.
