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40% of the US denture market relies on imports

The United States is the world's largest producer and consumer of dental devices, and its imported medical devices include dental restorations and materials. In the United States, dental restorations are 40% dependent on imports.

The situation of the American denture industry is not optimistic at present: the cost of imported equipment is lower than that of domestic equipment, so the tariff increase will not have much impact; many dental equipment companies in the United States are in the process of overseas competition and industry consolidation and solidification. In the wake of the tide, the functions of the dental technician will gradually be replaced by machines.

According to Elizabeth Curran, deputy director and associate professor of technology at the Dental Technology Institute of the School of Oral Health at the Arizona Medical College, “The fierce overseas competition and the American response have put the US dental equipment industry in a dilemma. Because of the dental technology and equipment. The materials used by the manufacturing company are also regarded as medical devices. After the tariff increase, if we use imported materials to make domestic restorations, the price will not be more advantageous than the direct use of imported restorations."

The translation of the arterial network has compiled the views of three American equipment industry practitioners to see what they think about the industry's turmoil and what actions will be taken to remain competitive.

Some ways to ensure competitiveness in the US dental equipment industry

“From the point of view of the dental equipment manufacturing and dental technology industry, this situation has been in existence for a long time. We expect the FOB price of related materials to continue to grow because of the pricing of DSO (Dental Service Organizations). The formula is based on the dental laboratory,” said Bennett Napier, executive director of the American Dental Science and Technology Association (NADL).

All along, although the low price of imported dental prostheses has made many dental clinics taste a lot of sweetness, it is very heavy for other related industries, especially dental laboratories.

Bennett Napier believes that industry competition is inevitable and will continue for both domestic and foreign. The real concern of dental laboratories is what qualities are used to stand out from the competition.

For foreign competition, Bennett said that they should first analyze what their value-added services are and what products they can offer that are beyond 5000 miles.

“Using digital technology, the world’s peers can communicate anywhere, anytime. There are always products and services that can only be provided by our dental technicians in the United States, but foreign counterparts can’t do it,” Bennett Napier continued. “We have to put ourselves Focus on these differentiated products and strive to make them bigger and stronger, and make these products irreplaceable."

“Only by putting services on the individual consumers can we further eliminate the prejudice that people have in their mouths and make them realize that this is not just a commodity that can be bought anywhere,” Elizabeth Curran stressed. “We Instead of doing small parts so trivial, it is providing personalized customization services."

Steve McGowan, head of the dental laboratory at Arcus in Seattle, said: "I think dental technicians, including bosses and technicians, should improve their professionalism through training and re-education to make themselves stand out, like more Understanding clinical dental knowledge and information becomes an irreplaceable partner for dental clinics, rather than repeatedly suppressing prices to resist competition."

He believes that dental equipment technicians need to be educated in all aspects of dentistry, including materials science and clinical dentistry. If the dental laboratory changes to the small parts processing plant model and claims to have a so-called high-order version of the workers, the owner of the mechanics may earn a lot of money, but for the dental technician, his career is basically the same. It is.

“The high-end version of the worker I’m talking about may not know how the denture was made from start to finish. I think our current system provides more training for the technicians than education,” continues Steve McGowan. “Most of our training in this field comes from manufacturers. They will teach you how to use the device, but they won’t teach you why. This situation has been going on for quite a while, I think it’s a A huge mistake in the industry."

In order to ensure competitiveness in the US market, it is necessary for the bosses of the dental laboratory to let their customers and potential customers know all the services that their laboratories can provide.

Bennett Napier expressed his opinion on this issue: "Many dental laboratories have neglected to promote their complete industry chain. Their products or services X are well known, but in fact they may also provide Y and Z products. And dentists may think that this lab can only do this type of repair product or provide a specific type of service, so I have to find another one this time. So dental technicians should learn to work with the clinic. Conduct all-round communication and show all your services."

According to the NADL 2017 Business Survey, 63% of the interviewed laboratories can provide a variety of services (usually capable of producing dental restorations such as crowns, bridges, porcelain teeth and implants at the same time), with the remaining 37% The dental laboratory provides only one service, and the size of such laboratories is generally small, often providing only denture or crown manufacturing services.

Bennett Napier continues: “If you want your dental laboratory to stand out from the crowd, you should emphasize your various service elements, complex treatment plans or related consulting services to your clients. This is especially true for cases with large-scale repair needs. From the perspective of dental customers, their various new needs are also increasing, so it is necessary for practitioners to communicate to them that they are also capable of fulfilling these needs."

He further clarified: "Full mouth edentulous reconstruction and complex implant cases are an important growth area for both dental clinics and dental laboratories. To complete these complex cases, a stable partnership is needed. Let dentists and dental technicians work together to deal with difficult problems and develop treatment plans. If this situation can develop benign, one day we can see technicians and dentists working together in dental clinics in the United States, and this is exactly abroad. It's hard to copy."

Dentists should have a deep understanding of the dental prosthesis they use.

According to Elizabeth Curran, dental school graduates now have very little training in dental technology, especially compared to dentists 25 years ago.

“Compared to past dentists, young dentists now rely more on dental laboratories, and the problem arises,” Curran said. “With the gradual stabilization of the American dental laboratory market, dentists must be more aware of their needs. To choose a more appropriate partner. They need to know where the problem is and what they need to communicate more effectively with the dental laboratory to meet their own and patient needs."

That's why Bennett Napier believes that NADL's focus has been on transparency over the past decade.

“We are not blindly rejecting overseas or pro-overseas markets,” Napier said. “It’s the era of a globalized economy. The fierce competition is generally positive for the entire industry environment. But we also need to recognize that transparency It is the most difficult pain point for the entire medical device and even the medical industry. We don't want a dental clinic to establish a partnership with the dental technicians simply because their products are domestically produced brands."

McGowan of Arcus Labs clarified why the United States has entered as many as 40% of dental restorations relying on imports. He said: "China's labor costs are low. You can customize a crown for $40. In the US, my asking price is $400. A crown of the larger dental laboratory may only cost $100, which is obviously much cheaper. The real competitor is actually China, but there is nothing to do but to adapt to the status quo. In fact, those Large-scale laboratories often outsource their business to China or other countries, but no one knows."

Now, NADL is actively promoting a campaign called “What’s In Your Mouth?” to increase the transparency of the dental prosthesis market and give patients and dentists more freedom to know.

NADL said that the disjointed information between patients in the dental laboratory is likely to lead to some key information not being delivered, such as where the restoration originated and what materials were used. At the same time, they appealed to those dental laboratories who would simply outsource their work to foreign countries and sell the finished products to dentists at a low price.

Even the state legislature of Washington State has taken action, they have passed a bill that will force the dental laboratory to publish information about its third-party outsourcing service providers.

It is important to constantly test and establish trust relationships before all states in the United States have enacted legislation to force the transparency of the dental laboratory. Testing is indispensable.

Bennett Napier suggested to the dental clinic: "You may have been working with a technician for a long time, or it may be recommended to you, but as you do in other businesses, you have the right and need to know all about the lab. Service details so that you can truly get the services and products you need."

Curran also advised the dentist: "There is a very basic question that you all need to mention to your partners. That is to ask if they can provide FDA approval documents for the materials used in the restoration, because the imported materials are not regulated by the FDA. So it's hard to determine if the materials you get are really needed. They may tell you that this ceramic is FDA-approved, but it may actually be a very bad foreign product."

Bennett Napier added that another question that can be asked about the dental laboratory is whether they have passed the independent certification. If the answer is yes, then ask the details.

“These are initiatives that show that they have a good reputation and can reassure their dentists. When working in clinical work, dentists think that the labs they work with have a standardized system and resources at their fingertips. Very peace of mind."

What is the future of the US dental equipment industry?

Bennett Napier firmly believes that the entire medical industry will continue to grow steadily: "I believe that as the dental clinical business continues to grow, the domestic dental equipment industry will grow in the market. Despite the cheaper imports, the industry's gradual integration and digital machinery The impact is very strong, but I still feel that it is the dividend period of the dental equipment industry."

“With the advancement of dental digitalization, the continued development of new materials and the proliferation of innovations in various industries, I am optimistic about the industry as a whole,” Napier said positively.

On the other hand, McGowan is not as optimistic as Napier. Although he also said that the decline of the dental laboratory industry in the United States is a multi-faceted and complex issue, he has always insisted that the education of dental technicians is the first to bear the brunt. If an industry's technical staff is more inclined to on-the-job training than formal education, then the industry may not be far from decay.

“I insist that regular formal education and broad basic education are definitely a top priority for technicians,” McGowan said. “If a person’s identity is a dentist, then everyone knows that he is definitely regulated. Education, and they have received relevant skills training, but if you say that you are a dental technician, it may be very subtle."

“I think NADL is working hard to make dental technicians' entry barriers even lower, because the turnover of this industry is really serious, but I think it is drinking and quenching thirst. Because this job is quite difficult, so people simplify it. It is definitely not worth the candle."

Elizabeth Curran said: "The United States is a country that does not control technicians. We have not adopted an organization to achieve strong supervision. I think that a large part of the reason is that many patients do not realize that the crown they use is actually made up of dentistry. For the craftsmen, the doctors should be the authority of the industry, but in fact many dental instruments are not made by doctors, and they are completely unregulated by doctors."

This view runs counter to the ADA report titled "Dental Future", which the authors write: "The technicians at the dental laboratory usually manufacture dental prostheses under the guidance of dentists, and dentists usually have Dental technicians' operational skills and knowledge reserves."

The report also concluded that formal education for dental technicians will gradually disappear, as the income gap between formalized and technically trained technicians is not significant for this entry-level position.

Interestingly, the authors of the report also believe that the decline in the proportion of formal system education may also be due to the better effect of on-the-job training. It’s awkward, it won’t take long, and you may see it.

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