Picking Your People

“Your employees represent your business through both interaction with clients and the quality of the work they produce,” says Alesha Snell, owner of Revolution Dental Prosthetics in Draper, Utah. “It is extremely important to have the right employees and a strong team overall.”

Complicating the issue is the dearth of formally trained young technicians entering the workforce. The number of ADA-accredited dental technology two-year college programs remaining in the US will soon drop from 17 to 15, and according to the National Association of Dental Laboratories (NADL) the first-year enrollment in these programs dropped from 551 in 2004-05 to 320 in 2014-15. For a reason behind this trend, consider this snapshot: Cornerstone Dental Labs hosted 500 high school students from local technical schools at its Huntingdon Valley, Pennsylvania, facility last year, and only one had been previously aware of the dental laboratory profession.

“The most difficult challenge involved with hiring technicians is the small candidate pool,” says Cornerstone Dental Labs owner Jay Collins, whose laboratory has gone from 12 employees to 40 in recent years. “You absolutely must use every option at your disposal to put together your team.”

Assembling a strong team is not as simple as hiring the best ceramist or removables technician for every open position. The modern dental laboratory often includes scanners, digital design stations, and milling machines. An increasing number of laboratories utilize 3D printers. Employees must be able to operate these machines and software programs efficiently and effectively.

“You are not always looking for that skilled technician now,” says Jerry Ulaszek, CDT, President of Artistic Dental Studio in Bolingbrook, Illinois. “In some cases, you are looking for someone who understands how to run a CNC machine or can be trained to do that. In others, you are looking for someone who is more familiar with a computer than they are with dental instruments and carving teeth.”

Prescriptions coming into the laboratory call for full-arch fixed removable prosthetics, custom-milled abutments, orthodontic appliances, and more. Many laboratories have brought these capabilities in-house, rather than outsourcing them and focusing on simple crown-and-bridge cases. With the help of sophisticated management software, laboratories are expected to turn many of these cases around in a matter of days.

“We make sure everyone in our laboratory is cross-trained so they can handle several different types of cases,” says Snell, whose laboratory specializes in removables. “However, certain types of cases, such as hybrids, require such a rare level of skill that only a few of our technicians work on them.”

Additionally, many laboratories now require employees with skills outside of dentistry, such as administrative and legal skills. Snell, for example, is in the process of registering with the FDA to CAD/CAM mill custom implant abutments, and she is adding a former paralegal to her team in an administrative role.

“It will be extremely beneficial to have someone in our laboratory who understands and is well-versed on legal issues and can offer input regarding FDA compliance and OSHA,” Snell says.

The FDA’s recent increased attention paid to laboratories indicates that legal aptitude will take on even more importance in laboratories in the next decade. Another expected development is increased interaction with the rest of the dental team as communication technologies continue to improve.

“Communication skills and an understanding, soothing approach with dentists will continue to be increasingly important in the future,” Snell says.

Administrative, legal, and communication skills are relatively common. Finding candidates for the more specialized laboratory positions can be a challenge, however.

Collins says he starts early — the aforementioned school field trip was one of many he hosts regularly, in an effort to identify future employees.

“During each visit, I speak with one or two kids who express interest in the dental industry but do not want to be chairside with a patient every day,” Collins says.

For more immediate openings, laboratory owners have several online options rather than the traditional method of placing an advertisement in the newspaper. Craigslist, job sites such as Monster, social media, and online forums are just some of the places where laboratory owners post jobs.

Word of mouth is another widely used method. Ulaszek offers his employees a $250 bonus for successful referrals. He also notes that consolidation has left many experienced dental technicians looking for jobs. Accepting a job with a larger laboratory such as Artistic Dental Studio, which employs 70 people, is often a more attractive option for these technicians than going into business for themselves because of the initial investment usually required to open a laboratory in the CAD/CAM era.

“For years, there was no such thing as a qualified, unemployed dental technician; there has always been a shortage,” Ulaszek says. “Now, qualified technicians often call us looking for jobs.”

Indeed, according to the NADL only 35% of newly hired technicians in 2005 had three or more years of experience, but in 2015 that number had risen to 52%.

Qualifying experience extends beyond laboratories now as well. With CAD/CAM becoming such an important part of the workflow, laboratories can turn to the manufacturer side for help, as Snell did when she hired CAD specialist Jesse Madsen, a former Certified CAM Instructor for B&D Dental Technologies.

“The training you receive from manufacturers or distributors just cannot compare to having a full-time CAD/CAM expert on staff,” Snell says. “Jesse has helped us accomplish things with advanced technologies that we never would have been able to do over the phone.”

Qualified candidates are not always so readily available, however. Collins says only one in every five people he has hired over the past few years has had laboratory experience.

Barbara Hodges, who co-owns Highland Dental Arts in Lexington, Kentucky, with her husband, Al, says they often have had to ease their requirements. Highland is currently a two-person laboratory but has employed 6-8 people in the past.

“Any familiarity with the dental industry can be beneficial,” she says. “I started in this industry as a dental assistant, and that experience helped me in the laboratory.”

Skills from outside the industry can be applied in the laboratory as well. Ulaszek had a part-time driver whose daughter had a four-year college degree in art, and when he heard she needed a job, he brought her in for an interview and testing.

“Her skillset included a strong grasp of spatial relations and a color acuity that is very high,” Ulaszek says. “We put her into the glazing and staining area in the CAD/CAM department, and now she is glazing and staining full-contour restorations.”

Testing is key, several laboratory owners agreed, and it should be catered to each laboratory’s specific needs. For example, in addition to testing for specific skills and general intelligence, Snell tries to determine candidates’ morals and ethics because she maintains a family atmosphere in her laboratory.

Collins puts candidates through an extensive screening process. Regardless of position, he uses DiSC, a personal assessment tool used to improve work productivity, teamwork, and communication.

“The test does not have any right or wrong answers,” he says, “but it helps us understand if a candidate will be a good fit within a department. One of the most valuable tools in our business is communication, and if someone’s personality or style gets in the way of communicating, I need to understand that.”

After the DiSC test, a phone interview, and a face-to-face conversation, Collins invites candidates to come to the laboratory and showcase their work.

“I try to overwhelm them,” he says. “I put pressure on them, not because that is our everyday work environment but because in a dental laboratory setting there is always seasonality. If on a particularly busy day my technicians cannot finish a case, that client will go find another laboratory.”

Collins continues his tough-love approach even after hiring an employee. For the first 90 days, he says, the employee is expected to listen and learn.

“On the 91st day, they can start offering opinions,” he says.

Training is increasingly important with less qualified and experienced candidates.

Snell takes a creative approach in her removables laboratory, requiring each new employee to make a denture that he or she then wears for a day.

“Understanding firsthand what the patient needs in terms of comfort is invaluable,” Snell says.

Collins supports and encourages his employees taking the CDT exam.

“I constantly push them toward further education,” he says. “I provide the means, but they must put in the work and pass."

The training process often requires a significant time investment. Effective management entails ensuring the job is done well the first time, rather than merely checking for and correcting mistakes.

“When we hired people with little or no experience, it took a month or more to fully train them,” Hodges says. “Al would spend time with them everyday to make sure that when the training process ended, they were really doing the work the way that he wanted them to.”

After investing large amounts of time identifying, hiring, and training an employee, the last thing a laboratory owner wants is for the employee to leave. Retention becomes extremely crucial.

Snell sets monthly goals for her employees, and if they reach them then they get percentage-based bonuses. Additionally, any time one of her employees brings in a new account, she pays them 10% of that business for the first three months.

According to the NADL 2016 Business Survey, the annual wage median for technicians at large laboratories (more than 25 employees) ranges from $21,840 ($10.50 per hour) for the least experienced to $88,000 for the most experienced. The median wages that small (fewer than 10) and medium-sized (10-25 employees) laboratories pay their employees falls within that broad salary spread. Previous NADL surveys indicate that the percentage of senior technicians making $65,000 or more annually rose from 48% in 2007 to 56% in 2015, and the percentage of newly hired technicians making $13 per hour or more rose from 20% to 44% in that same time period.

Certain positions require significantly much higher salaries, especially at larger laboratories where highly skilled technicians oversee less experienced employees. The NADL Business Survey indicates that approximately 75% of respondents said a CDT was a factor in compensation.

“Technology has allowed us to automate so much, and it allows technicians with less experience to contribute in the laboratory workflow, but it is still important to have a skilled technician verify that everything is up to our standards,” Ulaszek says.

Higher salaries, Ulaszek adds, are required for removables technicians, who still need a high degree of analog skill; for anterior ceramists capable of producing high-end work; and for implant specialists who can consult with dentists.

Flexible schedules are a necessary benefit in today’s world, several laboratory owners say. Parents often need to adjust their hours to pick up children from school or stay home with a sick child.

“My employees have the freedom to take breaks or take time off,” Snell says. “We have created a family atmosphere and a level of trust. It is important to me that my employees are happy.”

Collins says he believes in building a culture of discipline and entrepreneurial spirit so his laboratory is a place where innovative people want to work.

“My job as an owner is to respect my employees and provide an avenue through which they can express their talents but also understand that we are here to make money and help our dentists provide excellent patient care,” he says.