Why dental lab cases go missing, and how to stop it
Dental lab cases rarely get lost in transit. They go missing at the handoffs between the practice and the lab. Here is where, and how to stop it.
By the Tusko team
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A dental lab case almost never goes missing in the courier bag. It goes missing at a handoff, the moment it passes from one person or one inbox to the next.
The scan is taken and nobody writes the Rx. The lab asks a question and the answer sits in a voicemail. The due date lives in one person’s head.
The fix is the same at every handoff. Give each case one place to live, one owner and one date, and check that place every day.
A case goes missing at a handoff, not in transit
Follow one crown from the chair to the bench and back, and it changes hands at least six times.
Six handoffs between the chair and the seat
A flow of the six times one crown changes hands, with what goes wrong at each and what it looks like later: chair to front desk, practice to lab, lab to practice, bench to bench, lab to courier, and front desk to chair.
Chair to front desk
The scan is taken, and no Rx is written. The lab never hears about the case.
Practice
Practice to lab
The Rx leaves without the shade, the material or the date. The case waits on hold.
Both
Lab to practice
A question goes to a voicemail or an inbox nobody checks. Days pass with no answer.
Both
Bench to bench
Nobody outside the lab can see how far the case is. The practice phones to ask.
Lab
Lab to courier
The case ships, and nobody tells the practice. The box sits unopened.
Lab
Front desk to chair
The seat date was never matched to the lab’s date. The patient arrives before the case.
Practice
Everyone in that chain can be good at their job. The case still slips, because its details are spread across paper, phones and memory.
The case that was never sent
The quietest way to lose a case is to never send it.
A dentist checks a hygiene patient, sees wear and asks for a night guard. The assistant takes the scan, the patient leaves, and the next patient is already seated.
Dr. Joel Gaudet, the dentist who founded Tusko, describes it this way:
“I see a patient quickly and they need a night guard. My assistant does the scan, and I forget about it completely. I’m relying on my staff not to forget, and people aren’t perfect.”
Dr. Joel Gaudet, Wave Dentistry
Nothing was lost in transit, because nothing was ever sent. The lab cannot chase a case it has never heard of.
The scan has to become a case the moment it is taken, with a patient and a date on it. The rest of the Rx can follow the same day.
The question that never got an answer
A lab that receives an incomplete Rx has two choices. It can guess, or it can stop and ask.
Stopping is the right call, and it is also where cases stall. The question goes out by phone, email or text, to whoever picks up.
By the time it reaches the dentist, that appointment is days and many patients in the past. The chart is not in front of them, so the answer waits again.
Each round of phone tag costs time nobody planned for, and the seat date does not move with it.
Two habits shorten this. Send a complete Rx the first time, and keep every question attached to the case it is about.
Our guide on what to include on a dental lab prescription has a checklist for the first habit.
The status nobody can see
Once a case is at the lab, the practice has no view of it. The lab’s board, pans and software sit inside the lab.
So the front desk phones to ask, and someone at the lab stops work to go and look. Both teams lose time on a question a shared status would answer.
A case with no visible status is also easy to forget. Nobody notices it is stuck until its date has passed.
The real cost of phone tag between dental practices and labs looks at what those calls add up to.
The due date nobody matched to the seat appointment
Every case has two dates. The lab has the day it plans to ship, and the practice has the seat appointment.
On a paper lab slip, those dates are written once and then live in two buildings. If the lab’s date moves, the practice’s schedule does not know.
The gap shows up with the patient in the chair and no case in the building. The practice loses the chair time, and the patient loses the trip.
You can put your own numbers on that with the practice calculator.
The case that arrived and nobody noticed
Some cases make it all the way back and still go missing.
The courier drops the box at the front desk during a busy hour. It is set aside, and nobody links it to an appointment.
A week later the team is on the phone with the lab about a case that is twenty steps away.
Checking in every delivery fixes this. Open the box the day it arrives, match it to the patient and mark the case as received.
More labs, more places to look
Many practices send work to more than one lab, each chosen for what it does best. That is a sound way to work.
It also means more than one way of hearing back. One lab emails, another texts, and a third phones the front desk.
No single list shows every open case, so case tracking falls to whoever remembers. A lab with many practices has the same problem from the other side.
How to stop cases going missing
None of this needs new software to start. It needs one list and a few fixed habits.
- Keep one list of every open case. Every lab and every case type, in one place. If a case is not on the list, treat it as not sent.
- Create the case when the scan or impression is taken. Do it before the patient leaves the chair, even if some details follow.
- Give the list an owner. One named person checks it every morning, and someone covers when they are away.
- Send a complete Rx. Tooth numbers, material, shade, the due date and the seat date, every time.
- Confirm both handoffs. The lab confirms it has the case, and the practice confirms the finished case arrived.
- Check the list against the schedule. Each week, look two weeks ahead and find any seat appointment whose case will not be back.
- Keep questions on the case. Write the question and the answer where the next person will look.
A shared spreadsheet can carry this for a while. How to track dental lab cases in your practice covers where a sheet works and where it stops.
Labs can run the same list from their side. How dental labs can cut “where’s my case?” calls covers that.
When one shared case replaces the list
A list kept by the practice still leaves the lab with its own list, and the two drift apart.
The stronger fix is one case that both sides open. The Rx, the scans, every message and the due date sit on it, and both sides see the same status.
That is what Tusko does. The practice sends the Rx, the lab works the case, and Chair Time flags a late case before the patient sits down.
You can see how that looks for practices and for labs.
Whichever tool you use, the test is the same. Ask two people where a case is right now, and see if they give the same answer.
How often do dental lab cases go missing?
There is no reliable published figure, and it varies by practice. To find your own number, count the seat appointments in the last three months that moved because the case was not ready.
Who is responsible for tracking a lab case, the practice or the lab?
Each side holds part of it. The practice owns the Rx and the seat date, and the lab owns production and shipping. Cases slip in the gap between the two, so the record works best when both sides can see it.
What should we do when the patient is in the chair and the case is not back?
Tell the patient plainly, call the lab for a firm date, and rebook before the patient leaves. Then find the handoff where the two dates came apart, so it does not happen again.
Is a spreadsheet enough to track lab cases?
It can be for a small number of cases, if one person owns it and checks it every morning. It stops working when the lab cannot see it and every update depends on a phone call.
Related guides
A dental lab prescription has to name the patient, the teeth, the restoration, the material, the shade and the date. This checklist covers every case type.
Phone tag between a dental practice and its lab costs staff time on both sides and days on the case. Here is how to count it, and how to cut it.
Feedback helps a dental lab when it is specific, prompt and tied to a case. Here is what to say after a seat, when to say it, and how to raise a problem.