Incomplete prescriptions: how dental labs get a complete Rx every time
An incomplete Rx stops a case at the bench. Here is what goes missing, why it happens, and the intake habits that get a dental lab a complete Rx.
By the Tusko team
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A lab gets a complete Rx every time by doing two things. It makes the complete version the easiest one to send, and it checks every case the day it arrives.
Reminders and stern emails wear off. Forms and habits do not.
What incomplete means at the bench
An Rx can be incomplete in four different ways, and each one stops the case differently.
| Kind of gap | Example | What the lab has to do |
|---|---|---|
| Missing | No shade, no material, no date | Stop and ask |
| Vague | “Match the adjacent tooth” with no photo | Ask, or guess and risk a remake |
| Contradictory | The Rx names one tooth and the scan shows another prepared | Stop and confirm which is right |
| Unattached | The Rx mentions a bite scan that never arrived | Ask for the file again |
The missing kind is the easiest to catch. The vague kind does the most damage, because it looks complete until the work is under way.
Why a careful practice sends a thin Rx
A thin Rx is almost never carelessness. It is written between patients, by someone already thinking about the next one.
The form matters too. A paper lab slip with a large free-text box invites a short note, and a scanner’s notes field invites an even shorter one.
Habit plays a part. A dentist who has sent you work for years assumes you know their preferences, and is often right.
Then the question lands days later. Dr. Joel Gaudet, the dentist who founded Tusko, describes that moment from the chair side:
“A lab would call me: for Linda, what kind of pontic do you want? And I’m thinking, who is Linda? I’ve seen 45 patients today, and you’re asking me about a patient from three or four days ago.”
Dr. Joel Gaudet, Wave Dentistry
Both sides lose time in that call. The lab was right to ask, and the dentist had no way to answer well.
Make the complete Rx the easy one to send
People fill in what a form asks for. Change the form and the Rx changes with it.
- Ask for each detail by name. A field marked “Shade” gets a shade. A box marked “Instructions” gets whatever fits in ten seconds.
- Offer choices where you can. A list of the materials you work in is quicker to tick than to type, and it cannot be misspelled.
- Show only what the case type needs. An implant crown needs the implant system and the connection. A night guard does not.
- Mark what you cannot start without. If the due date is required, the form should refuse to go without it.
- Keep each dentist’s preferences on file. Contacts, occlusion and favourite materials can be defaults they only change when a case differs.
Tooth numbers belong on the list. Ask for FDI notation, written as “tooth 11”, so nobody has to work out which system a number came from.
Our dental lab prescription checklist lists the fields by case type, and you can hand it to your practices.
Put each dentist’s preferences on file
Some of what goes missing is preference, and preference seldom changes from case to case.
Ask each dentist once, and keep the answers where your team checks in cases.
- How tight they like contacts
- How they want occlusion left, in contact or slightly light
- Their usual material for back teeth, and for front teeth
- How to handle a doubtful margin: call first, or use your judgement
- The shade guide they use
A new dentist at a practice needs a sheet of their own. Preferences belong to the person, and two dentists in one building can differ.
Review a sheet when a remake suggests it is out of date.
Check every case the day it arrives
Even a good form lets some gaps through. The second habit is catching them on day one.
- Open every case within the working day. Read the Rx against the files before the case goes anywhere near a bench.
- Use the same short check each time. Patient, teeth, restoration, material, shade, date, files. Seven items make a quick check.
- Mark a stopped case as on hold. Everyone in the lab should be able to see that it is waiting, and for what.
- Ask once. List everything that is missing in a single message, so the dentist is interrupted one time.
Seven things to check on every new case
A checklist of the seven items a lab checks on every new case, the day it arrives: patient, teeth, restoration, material, shade, date and files.
- Patient
- TeethIn FDI notation, written “tooth 11”
- Restoration
- Material
- Shade
- DateThe day the practice needs the case
- FilesEvery file the Rx mentions
Timing is the whole point. Early in the schedule, a gap costs a message. Close to the due date, it costs the date.
Decide what can start without an answer
One missing detail does not always have to stop the whole case. Decide ahead of time which steps are safe.
Some steps do not depend on the gap. A model can be made before the shade is known, and a design can be drafted before a contact preference is confirmed.
Other steps lock the detail in. Anything that fixes the material or the colour should wait for the answer.
Write the rule down by case type. It saves a debate at the bench every time a case arrives one field short.
Note on the case what was started and what is waiting. The next person should not have to guess.
Ask in a way that gets answered
A question the dentist can answer in ten seconds gets answered the same day. Build each one the same way.
- Name the patient and the tooth first. The dentist has to find the case in their head before anything else.
- Say exactly what is missing. “Shade for tooth 21” is quicker to answer than “please confirm details”.
- Offer the likely answers. “A2 as on your last case for this patient, or something else” takes one word to settle.
- Show what you are looking at. A screenshot of the scan or the photo saves a round of back-and-forth.
- Say what happens next. Give the date you need the answer by to keep the ship date.
Write it down, and attach it to the case if your system allows. A voicemail carries none of this.
Close the loop with each practice
One fixed Rx helps one case. A pattern shared with the practice helps every case after it.
Once a month, tell each practice what you had to ask for and how often. Keep it factual and short, and send it to whoever fills in the Rx.
Share a good example as well. Many teams have never seen what a perfect Rx looks like from the lab’s side.
Thank the practices that get it right. The front desk and the assistants do much of this work and rarely hear how it landed.
What a digital Rx changes
A digital Rx makes most of this the default. Required fields cannot be skipped, and the files travel with the form.
On Tusko, practices send the Rx with the scans, photos and the date they need it, in one submission. Questions go on the case, beside the files.
See how that works for labs, or put your own numbers into the lab calculator.
Fewer gaps also means fewer calls. How dental labs can cut “where’s my case?” calls covers that side.
Complete cases are one of the reasons practices stay. How dental labs keep practices sending cases covers the rest.
Should a lab start a case when the Rx is incomplete?
Start only the steps the missing detail cannot change, and say so on the case. Guessing a shade or a material risks a remake that costs more than the wait.
What is most often missing from a dental lab prescription?
It differs from practice to practice, so count your own for a month. Shade details, the date the case is needed and implant specifics are sensible fields to check first.
How quickly should a lab check a new case?
The same working day. A gap found on day one costs one message. The same gap found on day four costs the due date.
Will a dentist mind being asked?
A clear, specific question is part of the service. A dentist would sooner answer one message than seat a crown that was guessed at.
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