3D printing night guards in-house: workflow and tracking

Printing a night guard in the practice takes seven steps, from the scan to the patient’s hand. The printer does one of them.

The other six are done by people, and each is a place for a case to sit. A practice that prints well has a name beside every step.

This guide covers what you need for dental 3D printing, the workflow, and how to keep a queue of printed appliances moving.

What you need before the first print

The printer is the visible purchase. A working setup has six parts.

Choose the resin with care. It must be one made for appliances worn in the mouth for long periods.

Ask your supplier to confirm it is licensed in Canada for that use, and keep the answer on file.

Follow the maker’s instructions for washing and curing exactly. Those steps decide the strength and safety of the finished guard.

The seven steps

Seven steps, and where each one stalls

A flow of the seven steps of printing a night guard, with who does each and where it stalls: scan both arches and the bite, write the Rx, design the guard, approve the design, print, wash and cure, finish and polish, and check the fit and deliver.

1. 1

   Scan both arches and the bite

   Stalls when the bite is missed, or the scan is saved and not exported.

   Assistant

2. 2

   Write the Rx

   Stalls when the type and arch are never written down.

   Dentist

3. 3

   Design the guard

   Stalls when the scan waits in a folder.

   A trained team member

4. 4

   Dentist approves the design

   Stalls when nobody asks, and the dentist is with patients.

   Dentist

5. 5

   Print, wash and cure

   Stalls when the print finishes and sits in the tray.

   Assistant

6. 6

   Finish and polish

   Stalls when it waits for a quiet hour.

   Assistant

7. 7

   Check the fit and deliver

   Stalls when no visit was booked.

   Dentist

Notice where the dentist appears. Steps two and four are short, and they are the two that hold up everything else.

Build them into the day. A dentist who approves designs at a fixed time, such as the end of the morning, keeps the queue moving.

Name a lead for the printer

One person should own the equipment, with a second trained to cover.

• Resin stock, and the expiry date on each bottle
• Cleaning and calibration, as the maker sets out
• The print-day routine
• The log of what was printed

A printer that belongs to everyone is maintained by no one.

Write a short Rx, even for yourself

It is tempting to skip the Rx when the lab is down the hall. That is how in-house cases lose their details.

Write five things for every guard.

• The patient
• The arch
• The type and thickness the dentist wants
• Anything about the bite the designer should know
• The date of the delivery visit

Note any tooth that is about to change. A guard made to today’s teeth will not fit over next month’s crown.

Night guards and splints: keeping appliance cases on track covers why these cases are the first to be forgotten.

Batch the work

A printer can build several guards at once. Printing one at a time wastes it.

Pick print days. Two a week suits many practices, with design finished the day before.

A fixed rhythm helps the front desk as well. They can book delivery visits knowing when prints will be ready.

Keep the day after a print day clear for finishing. A guard that is printed and not finished is no closer to the patient.

Do not print on a Friday afternoon unless someone will wash and cure before leaving. Follow the resin maker’s guidance on how long a print may wait.

Track the queue

An in-house case needs the same record as a lab case. Use the same stages for every appliance.

Put the list where the team can see it. A whiteboard by the printer works, and so does a shared sheet.

Look at it every morning. Any case that has sat at one stage for three days needs a name and a nudge.

Count the open cases at each stage once a week. A pile at one stage shows where time is short.

Our free case tracking sheet can hold in-house work if you add these stages to its drop-down.

Check every guard before it goes out

A lab checks its work before it ships. In-house work needs the same step.

• The right patient’s name is on the bag
• Supports are removed, and no rough spot remains
• The guard sits fully on the printed or scanned arch, if you have a way to check
• The thickness matches what the dentist asked for
• The resin batch and the print date are recorded

The last line matters if a batch of resin is ever recalled or a guard fails early. Without it, you cannot tell which guards were affected.

The dentist checks the fit and the bite at the delivery visit. A guard handed over at the desk misses that check.

Keep the files

Save three things for every guard: the scan, the approved design and the Rx.

Name them the same way every time. The patient’s initials, the arch and the date are enough.

The saved design is worth having. If the patient loses the guard and the teeth have not changed, it can be printed again.

Store the files where your practice keeps other patient records, under the same access rules.

Clear working copies off the printer’s own computer once the files are stored properly.

Know what to send out

Printing does not suit every appliance. Decide the rule before a case forces it.

Send a case to a lab when it needs a design, a material or a finish your setup does not offer.

Send it out as well when your queue is full. A guard printed three weeks late is no better than one a lab would have delivered in one.

When a print fails

Prints fail. A support lets go, or a layer does not form.

Do not deliver a guard you have doubts about. Print it again, and note the failure in the log.

If the same fault repeats, stop and call your supplier before the next batch.

Tell your lab what you now make yourself. In-house dental lab vs outsourcing covers how to draw that line and whether the equipment pays.

One list for everything

The risk with in-house work is a second system. Lab cases are tracked, and printed ones live in someone’s head.

Put both on one list, with one owner. How to track dental lab cases in your practice compares the ways to keep it.

For the cases that do go to a lab, Tusko keeps the Rx, the scans and the date on one case that both sides open.

See how it looks for practices.