Dental Laboratories and Dental Technicians

The prescription is the dentist's written instruction to the laboratory. 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 scan². 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 made³. Dental stone is a hard type of plaster. The wax is then replaced with metal, ceramic or acrylic³. 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 needed². The file can be sent to the laboratory electronically². 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 surgery⁴ 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 file⁴, so a conventional start can lead to digital manufacture. A framework (core) milled from a block can also be covered 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. Tell your dentist about any allergy, or any reaction you have had to a dental material. The technician can advise: the scope guidance 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 recommended³. 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 strength⁵. Ask for the material, the product name and the manufacturer of each restoration in writing.

Our pages on zirconia crowns and lithium disilicate glass-ceramic 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 dentistry³. 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 translucency⁵.

For complete dentures, the work goes back and forth between the clinic and the laboratory. A patient leaflet from a hospital in Leeds describes the stages. They include two sets of impressions, a bite record and a trial fit with some parts of the dentures in wax⁶. It notes that a second trial fit is often needed⁶, before the fitting and reviews. Our dentures page explains the treatment.

The technician usually cannot see your teeth, so the colour has to be sent 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 with it the shade is chosen in three steps⁷. 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 teeth⁸. 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. Examples are translucency (how much light passes through the tooth) 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 alone⁷.

Two meta-analyses compared choosing by eye with using instruments, such as cameras and spectrophotometers (devices that measure colour). One, from 2023, found that shades taken with instruments were on average closer to the target than shades chosen by eye⁸. The other, from 2022, found a larger colour difference with shade guide tabs than with computerised methods⁹. Digital photographs reduced the difference, but a spectrophotometer showed no clear advantage over the tabs⁹. Both reviews were based on few, mostly small studies. In the 2022 review, seven of the 13 studies were laboratory studies, and most of the clinical studies had a high risk of bias⁹. Neither review gives evidence on patient satisfaction or on how long restorations last.

A 2025 review advised against choosing the shade with an intraoral scanner¹⁰, although its evidence was of very low certainty.

Light, whitening and who takes the shade

• Light. How a colour looks depends on the light and on the background⁷. In a laboratory study, dentists with normal colour vision matched shades better under a standard daylight lamp than under a tungsten bulb¹¹.
• Whitening. The American Dental Association, in the US, says that whitening will not work on caps, veneers, crowns or fillings¹². If you want lighter teeth, say so before the shade is chosen.
• Who takes the shade. Usually the dentist, who records it and sends it to the laboratory with photographs.

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. You can also ask whether a technician can see you or your photographs.

Checks happen in the laboratory and again in your mouth.

In the laboratory

The scope guidance lists verifying and taking responsibility for the quality and safety¹ of devices leaving a dental laboratory among a dental technician's usual tasks. Before a restoration leaves, the technician checks it, on a physical model if one has been made. 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. A fixed restoration is cemented, bonded or screwed in place; a removable denture is put in and its fit is checked. 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 it³. 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 needed³. In laboratory studies, a smooth polish increased the strength of zirconia, while coarse grinding reduced it¹³. If a zirconia restoration is adjusted, ask how the adjusted surface will be finished.

The scope guidance refers to what dental technicians make to a prescription as custom-made dental devices¹. Turkey's medical device regulation says what records go with such devices.

The regulation was prepared in line with EU legislation¹⁴, 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 responsibility¹⁴.

The statement for each device

The maker draws up a statement before placing the device on the market¹⁴, and the device is accompanied by that statement¹⁴. 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 at least 15 years if implantable¹⁴. The regulation does not say in so many words that you receive a copy, so ask for one.

Your records

Private dental clinics record the diagnosis, the treatment and any X-rays in detail, with tooth numbers¹⁵. You can examine your file and records and get a copy¹⁶.

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 repeated⁶. After fitting, reviews to adjust and refine your denture⁶ are part of the process.

A remake usually needs laboratory time, and that can mean another visit.

If a restoration comes loose, breaks or hurts after fitting, contact your dentist without waiting for the next review. Do not try to adjust or repair it yourself.

Ask before treatment:

• who decides whether a restoration is adjusted or made again;
• how long a remake usually takes;
• how your prepared teeth are protected while the restoration is made or made again;
• whether a remake is included in your written plan, and who pays for it;
• what your written plan says if a problem appears after the restoration has been fitted.

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

• Design is the prescriber's responsibility. Turkey's medical device regulation describes the prescription as giving the design characteristics under the prescriber's responsibility¹⁴. For dental work, that is usually the dentist.
• Clinical care stays with the dentist. Turkish law authorises every dentist¹⁷ to diagnose and treat the teeth, the gums and the tissues of the mouth and jaw directly connected with them. The examination, the preparation of your teeth, the scan or impression, the fitting and any adjustment in your mouth are part of your treatment.
• A custom-made device starts with a prescription. Under the same regulation, the prescription is written by a person authorised by law, by virtue of their professional qualifications¹⁴, such as a dentist.
• 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 production¹⁴ and takes corrective action where needed. It reports adverse events to the authorities as soon as it learns of them.

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. A complaint goes to the clinic first. If it cannot be resolved there, you can apply to the Patient Rights Board¹⁶ of the provincial health directorate. The Board does not assess allegations of medical error.

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 your written plan says if a restoration does not fit, chips or breaks;
• whether a remake is included in the plan, and who pays for it.

What you are told. Turkey's patient rights regulation says what you are told before treatment. It includes who will carry out the treatment, where and how, the other options with their benefits and risks, and the possible complications¹⁶. You also have the right to be told, on request, who is treating you, and their role and title¹⁶.

Consent. In private dental clinics, you are asked to sign a consent form for every intervention¹⁵. Two copies of the form are signed, and one is given to you¹⁶. Ask for your copy.

Keep 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. A dentist who treats you later can then see what was done.

Your choice. You can say no, or ask to stop, at any stage. Once a tooth has been prepared, that step cannot be undone.