I learned that a dentist may charge you for a full priced dental implant made at a US lab, and then buys it from a lab in Asia/China at a fraction of the cost. Do you think this is fair or ethical? How can I make sure that I get one made by safe materials and from the US?
Dental Implants Made in China or Asia?
Doctor Answers 8
Offshore Lab Work
As far as the actual implant itself, as long as it is a major brand ( Astra, Zimmer, Straumann, are examples) the quality standards are very high and you don't need to worry about where they manufacture their products. Custom abutments and crowns are another matter. I would be very cautious of implant crowns at the low end of the price range for your area. Often these are porcelain fused to metal crowns which contain nickel instead of a precious metal such as gold. The issue with nickel is that many people, particularly women, are allergic to it. This increases the chances of problems later on. These are the types of crowns that are frequently made offshore for a very low cost and with questionable quality. Ask your dentist where lab work is sent.
Where Are Implants Manufactured?
You are asking a great question and I assumed that the companies I work with manufacture our Implants in the USA. We work with Nobel Biocare, Biomet and Astra Companies and will find out the answer. It never dawned on us that they may be manufactured elsewhere.
Our policy is to always work with the best supplies we can get and the charges are reflective of that. Thanks for asking the question-I plan to check to make sure our assumptions are correct. Asking your dentist is a good idea-
How to be sure your lab work is not from a foreign country
This is a very relevant question and is a hot topic in dentistry now. The lab the dentist uses may outsource its lab procedures to foreign countries to save money. Some of these foreign labs work for peanuts and use subpar materials and have no standard of care for sanitization or material composition (like lead in crowns). Some dentist that send work to larger labs may not even be aware where the lab work is sent. The patient needs to be vigilant and ask the questions to the dentist and ask for lab info and if the dentist is good they know exactly where they are getting their work.
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Dental Implant origins
When a dentist sends a case to a lab, most of the time the case is being sent somewhere in the United States. Some of the labs do not tell the dentist that they then outsource it to Asia/ China. Always ask your dentist where the lab work is being done and by whom. Ask to see the "Identceram Certificate" which states the materials that went into your lab work. The dentist can get a verification of where the work was actually done from the lab for you to see. As far of country of origin of the implants, many are made in Europe, Israel, and the United States. Ask the surgeon who places it, where the company is based. Many implant companies have US distribution. When I charge for this type of work, the actual lab cost is shared with my patients if they ask, and my fee is for my time and materials.
Dental Labs : US versus Foreign
I think that there are several issues here. The first is that i would make sure that the type of implant placed in your mouth is not a knock off, but a brand name implant that has been around and tested. The second is the crown or work that goes on the implant. You are correct, you do not want foreign work in your mouth. There were articles about this in the papers awhile back as the foreign labs are not under the same laws as US labs. In Texas, all lab techs must be certified.
Simply ask your dentist the same questions you have asked us.
Dental implant fees are for the service
While each dentist has their own overhead and may use many labs, the fees do not fluctuate. If you are on a PPO plan, the fees are set by the plan and cannot be changed. If lab outsources some labor to China, their fees are not significantly different, so not much of a savings to pass on.
If you don't trust your dentist, there are bigger issues. If you really want to know, ask your dentist to see the lab slip. However, some dentists don't know that their local lab outsourced some of their work and can produce a lab slip from a local lab, yet some of the work was done in Asia.
If you see a dentist and the fees are REALLY low, then a Chinese lab is likely involved. If the fees are normal or high for the area, the odds of a Chinese lab are less. Maybe.
The Foreign Connection
Unless your dentist charges separate material and labor costs, the question is moot. Dentist generally charge a reasonable fee to provide a service which includes material, labor, staff, overhead and other associated costs. Which country the dental products come from should not be of concern. I would be more concerned with the training, experience and reputation of the dentist.
The fact is that most dental materials are developed abroad. Many dental companies have offices in the US, but their products are developed, tested and manufactured in Europe and Asia. Even the "US companies" rely on offshore manufacturing facilities.
Dental materials and implants are medical devices. As such, the FDA must approve them for use in the US. Dentists in the US are obligated to use only FDA approved products. Regardless of the manufacturer or their global location, the product is safe.
Dental Implants By Legitimate Manufacturers
As long as you surgeon is using a legitimate known manufacturer, then there is no issue with the dental Implants themselves. I generally use Nobel Biocare Implants because of the decades of research the company has published and they back their products. Nobel is the Largest manufacturer in the world, they cost more than most others but my patients deserve the best and that's what they get. I also use Biohorizons which have a great deal of research behind them. At any rate as I mentioned above as long as the implants are not from a cut rate fly by night company ( which you need to be aware that there are many) you should be fine. The problem you speak of is actually with any lab work done overseas, particularly Asia. Usually crowns are made of porcelain fused to a gold substructure. There are other metals mixed with the gold for durability. Overseas labs have no quality control and often are high in nickel which can cause allergies and may even contain lead. Overseas labs are much cheaper than US labs which is why some doctors choose to use them, but you get what you pay for.