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DALLAS - Ever wonder who makes the dentures, crowns and bridges that enable Americans to show off their toothy grins?
Chances are, it's not a neighborhood dentist. It's a dental laboratory in the Philippines, Mexico, Costa Rica or China.
"Outsourcing in dentistry is a major concern of many lab managers," said David Tietz, 49, chief executive of Centric Dental Laboratory Inc. in Bullard, Texas. "Mom-and-pop shops will be hard-hit."
While they, too, can outsource their needs, quality becomes an issue, Tietz said. "Also, outsourced work loses that personal touch that makes laboratories different from each other."
But there's more fueling this trend than cheaper labor abroad. Problem is, the nation's limited supply of dental technicians can't keep up with the demand.
"Ceramics and cosmetic dentistry are still the buzzword," said Bennett Napier, co-executive director of the National Association of Dental Laboratories in Tallahassee, Fla. The ceramics niche crafts porcelain veneers for elective and necessary procedures.
"However, traditional restorative dentistry will drive the market, with the baby boomers needing more crowns, dentures and other similar dental care," he said.
Implants are hot as well, he said.
The American Dental Association in Chicago projects that employment opportunities for techs "will be excellent well into the next century," according to its brochure, "Word of Mouth."
Most techs work in commercial dental labs employing between two and 200 people. On average, a lab has five to 10 techs performing a spectrum of services or specializing in a specific kind of prosthesis such as partial dentures.
There are jobs in other settings, too, the association notes. Fewer openings arise in private dental offices, hospitals, schools and manufacturers of prosthetic materials.
"The dental techs in this country are still some of the greatest in the world," said Arlen J. Hurt, vice president of Specialty Appliances in Cumming, Ga., which specializes in orthodontics. "What will hurt our industry the most is not being aware of the market changes and reacting to them."
Education and training can begin in two-year programs at community colleges, vocational schools and similar institutions. Graduates earn a certificate or an associate's degree. Only a few universities offer a bachelor's degree in dental technology.
About 24 programs meet the standards of the Commission on Dental Accreditation, which is part of the American Dental Association. The programs have been dwindling due to declining enrollment and lack of funds.
"In 1985, we had 63 accredited schools of dental technology in the United States," recalled Emery Burdine, 69, president of Dental Dynamics Laboratory Inc. in Arlington, Texas. "Now they're closing them every day."
Most techs learn on the job, but Burdine says the monetary incentives aren't there. He estimates the starting wage to be about $9 hourly. With experience, the rate climbs to $20.
"Mostly, wages are dependent on your skill level and what part of the country you live in," said Milton C. Pokladnik, 64, executive director of the Dental Laboratory Association of Texas.
Earnings range from minimum wage for someone off the street to $15 or $20 per hour or higher for bench technicians, he said. Managers can rake in $100,000 "in the right place."
It usually takes five to seven years to become a well-trained technician. Some specialize in only one facet of technology - for example, waxing or finishing, Pokladnik said.
Technicians can take a test administered by the National Board of Certification, which falls under the National Association of Dental Laboratories. In most states, this is voluntary. However, in Texas, a lab is required to employ at least one certified dental technician.
Good manual dexterity, artistic skills and hand-eye coordination make a big difference.
"I came to this country from Brazil 25 years ago," said Denis Cavendish, 47, owner of Fine Arts Ortho Lab in Dallas. He has taken many courses and seminars, but most of his education has been hands-on.
"I spoke little English and learned the business from a Brazilian friend of mine," Cavendish said. "He let me apprentice for a few months and discover I was naturally inclined to do this."
(c) 2005, The Dallas Morning News. Distributed by Knight Ridder/Tribune News Service.