Cashing in on certification

There are many reasons dental technicians and dental laboratories pursue certification, but a direct impact on the bottom line is rarely the primary motivator.

Achieving a CDT (Certified Dental Technician) or CDL (Certified Dental Laboratory) is a major accomplishment and an important milestone in the careers of many people dedicated to their careers in the dental lab industry. For those who’ve passed the tests and meet the continuing education requirements necessary to achieve and retain certification, their triumph speaks to their personal dedication to producing the highest quality restorations.

“There isn’t any kind of accolade other than your own personal pride that you want to be the best you can be in your field,” said Norbert Duepner, Master CDT, who currently works as Technical Director for Argen Corp. “Not everybody can get it and not everybody can maintain it.”

Personal value

Certification has meant a lot to Duepner, who earned his CDT 52 years ago and has maintained it ever since despite spending 14 years living and working in Mexico where he had to do all his CE via the mail. While the title was a requirement for him to hold his current job, he said being a CDT hasn’t really been mandatory for other positions he’s held, but it’s helped him stay on top of changes in materials, techniques and technologies, while constantly reminding him what he loves about his work.

“It is a noble calling because you’ve got to put a lot of time and work into this job to be a good technician,” he said. “It’s always advancing, you always have to learn what’s going on that’s new and you don’t get a whole lot of pay out of the amount of time you put into it.”

That doesn’t mean the education, practical skills and recognition in the industry are not without value. Laura Sheppard, CDT TE, of DSG Davis Dental Laboratory in Wyoming, Mich., is the current chair of the National Board for Certification in Dental Laboratory Technology, and she said that while it’s troubling that achieving certification rarely means a bump in pay for a new hire, CDTs possess the skills and drive labs are looking for, and their dedication to their own education sets them apart from other technicians working in that lab.

“I’m sure any CDT will tell you this. Once you become certified you’re experienced enough in all areas of that particular specialty that you are the one most likely to succeed. You are the one that is most equipped to step right into a management position,” Sheppard said. “I don’t know very many CDTs who don’t have a job or who can’t get hired.”

But just as with Duepner, Sheppard said her journey toward certification was based on a personal drive to learn about all aspects of the industry. While she said the industry might be in better shape if there were universal requirements for formal technician training, for now CDTs really stand out because just by attaining that status. By attaining CDT status they’ve already proven they are self-motivated and able to accomplish their goals.

This is certainly the case for Jazel Mendoza, CDT, who earned her certification as a technician two years ago after spending 12 years working chairside as a dental assistant. Mendoza said she grew tired of seeing dentists struggle when seating restorations and wanted to help them by creating restorations that reached for a higher standard.

Since achieving her certification, she’s gone to work as an in office technician working closely with the dentists in the practice. Her technical education has prepared her to handle the work and provided her with the expertise to become a valued resource for the dentists with whom she works.

“Becoming a CDT has impacted my life in the most positive ways. It’s been an eye opener,” she said. “I can now help my dentists by giving them feedback and help them achieve their goals for their patients.”

Out of the shadows

Mendoza said she believes the CDT title is something dentists can count on when looking for quality in a lab technician. However, recognition from the operatory is not as widespread as many people involved with certification would like. Rachel Luoma, Chief Staff Executive of the National Board for Certification in Dental Laboratory Technology, said more than 1/3 of dentists do not realize technician certification is voluntary in most states.

However, the NBC and the NADL are working to promote education and training in the industry and to raise the profile of CDTs to both dentists and their fellow technicians. Sheppard admitted that the industry has a long way to go because the public and even dentists know little about what goes on in a dental lab.

“We're like the men in black, no one knows we exist,” she said.

Luoma cited the Foundation for Dental Laboratory Technology which was created to promote training in the industry as one step toward raising the profile of dental labs, while Sheppard said the NBC and NADL do have PR efforts underway to inform dentists about what working with a CDT really means. The message they’re trying to spread is that more widespread certification means higher quality restorations for patients, Luomo added.

“As we inform and educate dentists that technicians and labs are not regulated, then certification seems more appealing to them because then they can have piece of mind that their technician or their laboratory has met high standards and continues to meet those standards on a regular basis,” Luoma said.

Steps toward the goal

Meeting those standards is no small accomplishment, but it’s not insurmountable either. Luoma said the requirements for certification likely go beyond the benchtop apprenticeship many technicians received when they first came to the industry, but with study they can fill in any gaps and be ready to pass the two written and one hands on exams required to attain certification in one specialty area such as ceramics or orthodontics.

While the exams required to achieve the title of CDT have changed over the years, Sheppard said the core knowledge required to be recognized as an expert in the field has not. While each CDT starts out being recognized for a specialty, the exams are based on a comprehensive approach to the work done in dental labs, and all CDTs have some knowledge of all specialties.

This definitely sets CDTs apart from the technicians in the industry who have been trained for one special task in their lab such as waxing cases or finishing crowns, Sheppard said. Many of those technicians have little time to learn other aspects of the work in the lab, but those who make the personal choice to pursue further education and training are also showing their employers that they are prepared to take on more responsibility.

The NBC tries to make attaining a CDT accessible for technicians who already have benchtop experience. While the core knowledge required to pass the written examinations might have been part of their training, many have experience that would help them pass the practical exam. In any case, the NBC has study guides and other materials available to help technicians who are not able to go back to school with their efforts to gain the required knowledge on their own.

“In 8 months if all you did was study on your lunch hour you’d be ready to take your CDT. The practical you already know,” Sheppard said about experienced technicians who want the recognition that comes with earning a CDT.

Staying on top

Once a technician earns their certification, he or she is not done with education and training. Maintaining certification requires at least 12 hours of continuing education a year. Luoma said the CE requirements include at least one hour spent on regulatory standards, six hours of scientific training and five hours that can be used for almost anything including professional development.

These hours can be dedicated toward your specialty or learning a new area of the industry. There’s no requirement that a CDT focus on new technologies or changes in techniques, but Duepner said the CE requirements are a great motivator for someone who has already proven themselves to be a top technician to seek out new areas of study and experience.

“You could be recertified without getting into some of the new materials, but it’s your personal interest to keep up on what are the new challenges in the field,” he said.

While learning about the latest developments in the field is not a requirement for CDTs, Sheppard said technicians who have achieved this recognition have set themselves up to get the most out of the new technologies, techniques and materials being used in some parts of the industry. CDTs will know the basics and are ready to drive these systems rather than simply following their prompts which means they can provide a level of quality control that someone trained on only one system cannot.

“If you didn’t understand your core basics, what your margins should look like, the depth of color in a crown, the shading, the translucency and the intensity of color. If you don’t understand the anatomy and the way it should be functioning with occlusion, those are all basic core principles, then you can’t really work with CAD equipment either,” she said.

Not just for technicians

Just as the CDT title is something that can help set a technician apart from his or her peers, the CDL title can do the same for a dental laboratory. Certifying a lab is about codifying and adhering to safety standards in the way the business is operated. Luoma said the goal is for a CDL will tobe ready for an inspection should OSHA knock at the door.

There are no universal regulations to require labs to meet specific standards or follow specific operating procedures, but the voluntary requirements set out in the CDL program are a way for labs to show they operate under good practice protocols and to a certain professional standard. Sheppard said the requirements are not as detailed or stringent as those a lab must meet for DAMAS certification which relates to FDA regulations, but labs seeking to reach that standard can achieve CDL status as a landmark along that path.

“The bottom line is the safety for the patient,” she said.

Ready for the future

Even though none of these certifications is universally mandated, Sheppard believes they are growing more important in the industry. To date, three states mandate a CDT in each laboratory and the National Association of Dental Laboratories along with the NBC are working with 9 other states on legislation efforts. While dental labs may have been hidden from the public eye in the past, information is everywhere via the Internet, and unfortunately the industry comes to the public’s attention most often when something goes wrong with a material or a large number of restorations.

The days of dental labs operating out of the view of federal and state regulators seems to be on their way out and OSHA or the FDA visiting a lab is not a rare event. Sheppard said she believes the industry will eventually be more stringently regulated, and proactive certified labs and technicians will already be set up to handle that new landscape when it arrives.

“All of this is going to be critical at some point to staying in business,” she said.

Doing that in the face of change takes dedication, which is exactly what the CDT and CDL programs are about. If regulations and formal training become requirements to operate a dental lab, the industry will change, but while the programs remain voluntary they will continue to be about the personal accomplishment and enhanced self worth that come from being dedicated to your profession and the industry in which you work.

“It’s a personal thing. It’s a matter that you personally want to advance yourself to have something to be proud of,” Duepner said. “You have to be enough into it to really care to better the whole industry.”