Dental Laboratories and Dental Technicians

The prescription is the dentist's written instruction to the laboratory. In Great Britain, MHRA guidance says a written prescription may take the form of a letter², or of an impression sent with an order. The technician can only make what the prescription and the records show.

What usually goes to the laboratory

• What to make: the type of restoration, the teeth involved and the material.
• A record of the prepared teeth and their neighbours: an intraoral scan, or an impression or a model made from it.
• The opposing teeth and your bite, so that the restoration meets the teeth it bites against.
• The shade, usually with photographs (see "Shade and aesthetic communication").
• For implant work, the implant system and the position of each implant.
• Other instructions, for example on shape, length, the edges and how the restoration will be fixed.

When the laboratory needs more

A scan records only what the scanner can see. If the file reaches the laboratory while you are still at the clinic, the technician can ask straight away for another scan³. A problem found later may mean another visit. Our digital scanning page explains how scans are taken and checked.

Ask whether you can see the prescription, or a summary of it, and keep a copy with your records.

Laboratories work in two broad ways, and many combine them.

Conventional

A 2014 review describes the conventional route: an impression is taken, a stone model is poured and a wax pattern is made⁴. The wax is then replaced with metal, ceramic or acrylic⁴. Porcelain can also be built up in layers by hand, and some ceramics are pressed.

Digital

When the work starts from a scan, no plaster model is needed³. The file can be sent to the laboratory electronically³. The restoration is designed on a computer and then milled from a block or 3D-printed. A model can still be printed when one is needed. A 2021 review names working models for diagnosis and surgery⁵ as the most common use of 3D printing in dentistry.

Mixing the two

An impression or a plaster model can be scanned to give a digital file⁵, so a conventional start can lead to digital manufacture. A milled core can also be finished with porcelain layered by hand.

Which route is used depends on the restoration, the material and the equipment of the clinic and the laboratory. Neither route suits every case. Our CAD/CAM page explains digital design and manufacture, and what studies show about restorations made this way.

The dentist chooses the material with you. The choice depends on the tooth, your bite and the appearance you want. The technician can advise: the GDC lists advice and guidance to the clinical team on dental appliance design¹ among a dental technician's usual tasks.

The dentist and the laboratory also settle the design:

• the shape and length of the teeth;
• the thickness of the material;
• where the edge of the restoration sits;
• the contacts with the neighbouring teeth;
• how the restoration meets the opposing teeth.

Each material needs a minimum thickness. Where there is not enough room, a 2014 review says a change to the tooth preparation can be recommended⁴. That is a decision for the dentist, with you.

Products differ, even within one material. In a review of laboratory tests, lithium-based blocks from different manufacturers differed in composition and strength⁶. Ask for the material, the product name and the manufacturer of each restoration in writing.

Our pages on zirconia (often called zirconium) and lithium disilicate explain two of the ceramics that laboratories use.

The steps depend on the restoration and the material. The outline below is typical for a crown or bridge, and our dental crowns page explains the treatment itself. According to a 2014 review, milling is the most widely used computer-aided manufacturing method in dentistry⁴. Pressing, casting and building up porcelain by hand are also used. Some ceramics are fired after milling. For example, some lithium disilicate blocks are fired to reach their final strength, shade and translucency⁶.

For complete dentures, the work goes back and forth between the clinic and the laboratory. An NHS hospital leaflet from Leeds describes the stages. They include two sets of impressions, a bite record and a trial fit with some parts of the dentures in wax⁷. It notes that a second trial fit is often needed⁷, before the fitting and reviews. Our dentures page explains the treatment.

The technician usually cannot see your teeth, so the colour has to travel with the prescription.

Shade guides and codes

Most often the dentist holds tabs from a shade guide next to your teeth and records the closest one. Two widely used guides come from the same maker. One has 16 tabs; the other has 26 tabs and chooses the shade in three steps⁸. A code such as A2 only means something together with the guide it comes from.

No guide covers every natural tooth colour. A 2023 review notes that the available shade guides do not represent the true colours of teeth⁹. The code is a starting point for the technician, not an exact colour.

Photographs and instruments

Photographs of the chosen tab held next to your teeth show what a code cannot, such as translucency and the look of the neighbouring teeth. Choosing a shade by eye alone is subjective: a 2024 review advises clinicians not to rely on their senses alone⁸.

Two meta-analyses compared methods. One found that shades taken with instruments, such as spectrophotometers and cameras, were on average closer to the target than shades chosen by eye⁹. The other found that digital photographs reduced the colour difference, but that a spectrophotometer had no advantage over shade guide tabs¹⁰. Both were based on few, mostly small studies.

A 2025 review advised against choosing the shade with an intraoral scanner¹¹, although its evidence was of very low certainty.

Light, whitening and who takes the shade

• Light. In a laboratory study, dentists with normal colour vision matched shades better under a standard daylight lamp than under a tungsten bulb¹².
• Whitening. The American Dental Association, in the US, says that whitening will not work on caps, veneers, crowns or fillings¹³. If you want lighter teeth, say so before the shade is chosen.
• Who takes the shade. Usually the dentist. In the UK, GDC guidance lets dental technicians see patients directly, outside a dental team setting, only for denture repairs and shade taking¹.

Ask to see the chosen tab next to your own teeth. For front teeth, ask whether the shape and colour can be tried in your mouth before the restoration is finished.

Checks happen in the laboratory and again in your mouth.

In the laboratory

In the UK, a dental technician's usual tasks include verifying and taking responsibility for the quality and safety¹ of devices leaving a dental laboratory, according to the GDC. Before a restoration leaves, the technician checks it on the model. The checks cover the fit at the edges, the contacts, the bite, the thickness, the surface and the colour.

At the clinic

• Try-in. The dentist checks the fit, the edges, the bite and the colour in your mouth, and adjusts the restoration if needed.
• Fitting. The restoration is cemented, bonded or screwed in place, and the bite is given a final check.
• Review. At a later appointment, the fit at the gum and the bite are checked again.

A model is not your mouth. The fit and the bite can only be fully judged in your mouth, and so can the shape and colour of front teeth. That is why the try-in matters.

Adjustments have limits. For zirconia, a 2014 review warns that adjusting it after sintering can weaken it⁴. Sintering is the furnace firing that gives zirconia its final size and strength. It says zirconia restorations should be made accurately so that hand adjustment is not needed⁴. In laboratory studies, a smooth polish increased the strength of zirconia, while coarse grinding reduced it¹⁴. If a zirconia restoration is adjusted, ask how the adjusted surface will be finished.

The GDC calls what dental technicians make to a prescription custom-made dental devices¹. Medical device rules say what records go with them.

In Turkey

Turkey's medical device regulation was prepared in line with EU legislation¹⁵, including the EU Medical Device Regulation. It defines a custom-made device as one made for a particular patient to a written prescription that gives specific design characteristics under the prescriber's responsibility¹⁵.

The maker draws up a statement before placing the device on the market¹⁵, and the device is accompanied by that statement¹⁵. The statement includes:

• the name and address of the manufacturer and of all its manufacturing sites;
• data that identify the device;
• that the device is for one patient, identified by name, initials or a code;
• the name of the person who wrote the prescription and, where applicable, their health institution;
• the characteristics of the device as prescribed;
• a declaration that it meets the regulation's general safety and performance requirements or, where some are not fully met, which ones and why.

The statement is kept for at least 10 years after the device is placed on the market, or 15 years for an implantable device¹⁵. The regulation does not say in so many words that you receive a copy, so ask for one.

Turkey's health tourism regulation entitles international patients, on request, to free copies of the records of the materials used¹⁶, the tests and the imaging.

In Great Britain

MHRA guidance applies to medical devices placed on the market in Great Britain² (England, Wales and Scotland). We describe it for comparison with Turkey's rules above. Under it, a statement must go with a custom-made device that would have been classified as either a class IIa, class II(b) or class III device². A device in class I needs none. The guidance does not say which class a crown or a denture is in. Where there is a statement, it should be available to the named patient². The guidance also makes it a requirement that patients are made aware that they can request a statement².

What to ask for in writing

• the name and address of the laboratory that made each restoration;
• the material, the product name and the manufacturer, with the batch (lot) number where there is one;
• the shade, and the shade guide it comes from;
• for implant work, the implant system and the parts used;
• a copy of the statement for each custom-made device.

Small adjustments are a normal part of fitting. The dentist may adjust the bite or the contacts at the try-in, at the fitting or at a review.

Sometimes a restoration goes back to the laboratory, or is made again. Reasons include:

• the fit at the edges is not right;
• the bite is wrong and cannot be corrected by a small adjustment;
• the colour or shape does not match what was agreed;
• a ceramic has chipped or cracked;
• the tooth or the gum has changed, and a new scan or impression is needed.

For dentures, the Leeds leaflet notes that sometimes a stage may need to be repeated⁷. After fitting, reviews to adjust and perfect your denture⁷ are part of the process.

A remake usually needs laboratory time. That can mean another visit and, if you live in the UK, another trip.

Ask before treatment:

• who decides whether a restoration is adjusted or made again;
• how long a remake usually takes;
• who pays for a remake and for any extra trip;
• what the written terms say if a problem appears after you are home.

The laboratory makes the device; it does not treat you.

• Design is the prescriber's responsibility. In Great Britain, MHRA guidance says it is the qualified person who is responsible for specifying the particular design characteristics² of a custom-made device. For dental work, that is usually the dentist. Turkey's regulation also describes the prescription as giving the design characteristics under the prescriber's responsibility¹⁵.
• Clinical care stays with the clinician. The MHRA says the rules for manufacturers are not intended to interfere in any way with the professional and clinical responsibilities of the prescriber². Its examples of the healthcare professional's activities are preparation, impression taking, prescribing, final fitting and any adaptation². These fall outside the UK medical device regulations.
• No prescription, no device. In the UK, GDC guidance says dental technicians do not provide dental appliances for patients without a prescription¹. The prescription comes from a dentist or a clinical dental technician. Nor do technicians supply appliances directly to the public.
• The maker's duties continue after delivery. Under Turkey's regulation, the maker of a custom-made device reviews and documents the experience gained after production¹⁵ and takes corrective action where needed. It reports adverse events to the authorities as soon as it learns of them.
• One exception in the UK: dentures. Clinical dental technicians are a separate registered group. They can provide removable dentures directly to edentulous patients¹, meaning people with no natural teeth, roots or implants.

In short, the laboratory answers for making the device as prescribed and checking it before it leaves, and the maker keeps duties after delivery. The dentist answers for the diagnosis, the plan, the prescription, the preparation of your teeth and the fit in your mouth.

Ask the clinic in writing who is responsible if a restoration fails: the clinic, the laboratory or both. Ask too how a problem found after you are home is handled, and for a copy of the clinic's complaints procedure.

Before treatment, ask in writing:

• whether your restoration is made in the clinic's own laboratory or an outside one, and where;
• who makes it, and what qualification they hold;
• the material, the product name and the manufacturer for each restoration;
• whether you will receive a copy of the statement for each custom-made device;
• what the written terms say if a restoration does not fit, chips or breaks, including after you are home;
• who pays for a remake and for any extra trip.

Bring home for your UK dentist a written record of each restoration: the material, the product, the shade and its guide, and the laboratory. For implant work, add the implant system and the part details. Ask for copies of your scans and X-rays as well.

Aftercare. Problems after you return are usually first seen by your own dentist in the UK. If you do not have one, it helps to find one before you travel. The General Dental Council suggests speaking to your own dentist¹⁷ before you consider treatment abroad; ask whether they will see you afterwards. The NHS website for England says the NHS is not liable for negligence or failure of treatment¹⁸ abroad. It also says that most travel insurance policies will not cover you for planned treatment abroad¹⁸. Scotland, Wales and Northern Ireland run their own health services, with their own rules, which this page does not cover; if you live there, ask your dentist.

Your choice. Dentists in the UK also work with dental laboratories, and a UK opinion gives you something to compare. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.

Our dental crowns page lists the questions the General Dental Council and the NHS suggest you ask before treatment abroad.