1. The Work Ticket: More Than a Job Number
For many laboratories, the work ticket is the document that follows a case from prescription through manufacture and dispatch. It may contain the patient or case identifier, prescribing clinician, requested device, dates, material information, technician notes, design decisions, communications and quality-control information. Its exact format will vary between laboratories, but its professional value is much greater than simply providing a job number or an invoice reference.
The GDC Standards for the Dental Team require registrants to make and keep contemporaneous, complete and accurate records. The GDC specifically identifies laboratory prescriptions and statements of conformity as records that may form part of a patient’s records where they are available. Documentation should be clear, accurate and readily understandable by others.
This matters because laboratory work is collaborative. The technician who starts a case may not be the person who finishes it. A colleague may need to understand why a particular material was used, what information was received from the clinician, why a case was placed on hold, or what alteration was requested. Good documentation allows the work to continue safely without relying on memory or informal conversations.
The work ticket can therefore perform several functions at once: it communicates the prescription, records important manufacturing information, supports traceability, provides evidence of decisions and communications, and contributes to the laboratory’s quality-management system.
It is also important not to overstate what a work ticket represents. The ticket is not automatically a substitute for every document required under medical-device legislation, nor does the presence of a detailed ticket by itself demonstrate that a device is compliant. Instead, it forms part of the wider documentation and quality system used by the manufacturer.
2. Recording the Prescription and Changes to the Case
A laboratory cannot manufacture safely from assumptions. The prescription establishes what the prescribing clinician has requested, while the laboratory record should make clear how that request has been interpreted and acted upon.
In practice, prescriptions are not always perfect. A shade may be missing, the design may be unclear, the preparation may not provide the expected space, the bite registration may appear inconsistent, or the requested material may not be appropriate for the intended design. These situations are part of normal laboratory communication and should be managed through appropriate communication rather than silent assumptions.
When clarification is required, the important point is to record the relevant communication. A short note such as “called practice — clinician confirmed shade B1” may be sufficient for a straightforward matter. A more significant technical decision may require greater detail, particularly where the original information was ambiguous or the change affects the finished device.
Technicians should distinguish between a clarification and a change. If the clinician confirms information that was already implicit in the prescription, the record should show that clarification. If the clinician changes the requested design, material or other specification, the revised instruction should be clearly recorded according to the laboratory’s procedures.
Where instructions are received verbally, a written confirmation can be particularly useful for significant decisions. This does not mean every telephone call needs a lengthy transcript. The objective is a proportionate record that captures what matters: who provided the instruction, what was agreed, and any important limitation or concern identified by the technician.
Good documentation also protects against a common laboratory problem: retrospective reconstruction. Months later, it may be difficult to remember exactly what was discussed. A short contemporaneous record is generally much more useful than trying to reconstruct the conversation after a complaint has been received.
3. When the Case Does Not Go to Plan
Dental laboratory work rarely follows a completely predictable path. An impression may be distorted, a scan may contain insufficient information, a preparation may not provide the expected clearance, a model may be damaged, or a manufacturing stage may produce an unexpected result.
The professional response is not to hide the problem or simply work around it without recording what happened. Instead, the technician should identify the problem, consider whether it affects the quality or safety of the device, communicate appropriately and record the relevant action.
This is where the work ticket becomes particularly valuable. A concise record can show that an issue was identified, what decision was made and whether the case was placed on hold, returned for further information, remade or completed following clarification.
For example, “margin unclear on distal aspect of preparation — case placed on hold and practice contacted” provides considerably more useful information than “bad prep” or “dentist informed”. The first describes an observation and an action. The second provides little information for another person reviewing the case later.
Technicians should also avoid turning technical records into commentary about the prescribing clinician or patient. The purpose of the record is to communicate information relevant to the case, not to express frustration. Objective language makes records more useful and reduces the risk of misunderstandings.
The same principle applies when something goes wrong within the laboratory. If a restoration fractures during processing, a digital design is accidentally altered, a material is used incorrectly, or equipment produces an unexpected result, the record should support the laboratory’s investigation rather than simply documenting that a remake was required.
4. Complaints: From Difficult Conversation to Useful Information
Complaints can feel uncomfortable in a laboratory environment, particularly where the relationship with the dental practice is commercially important. However, the GDC is clear that complaints should be handled properly and professionally. Principle 5 requires an effective complaints procedure and states that complaints should be dealt with promptly and constructively.
For a laboratory, a complaint may come directly from a patient, from a prescribing clinician, from another member of the dental team or through the organisation responsible for the service. The exact process will depend on the laboratory’s role and the arrangements in place with the dental practice or other organisation.
It is useful to distinguish between a complaint, a remake and a technical query. A remake may be a routine part of laboratory work and may not constitute a formal complaint. Equally, a repeated request for remakes or a pattern of dissatisfaction may reveal a more significant issue. The laboratory should have a clear procedure for deciding how different types of feedback are recorded and managed.
When a complaint is received, the first response should not be defensive. Listen carefully, establish what the concern actually is, acknowledge it appropriately and follow the laboratory’s complaints procedure. Where the complaint relates to a specific case, preserve the relevant records and avoid altering them simply because a complaint has been made.
A useful complaint record should capture the substance of the concern, the case involved, relevant dates, the investigation undertaken, the response provided and any actions arising from the investigation. The GDC also recommends keeping a written record of complaints and using complaint information to monitor performance and identify areas for improvement.
A complaint is therefore not only an event to be closed. It is information. If several complaints involve the same stage of manufacture, material, design process or communication problem, the pattern may be more important than any individual case.
5. Remakes, Root Cause and Learning from Failure
A remake is often treated as a simple production statistic: how many cases had to be remade and how much did they cost? A stronger quality approach asks a different question: what caused the remake, and what can the laboratory learn from it?
Root-cause analysis does not need to be complicated. The first step is to describe the actual failure. Was the restoration clinically unsuitable, technically incorrect, damaged during manufacture, damaged during transport, or returned because expectations had not been communicated clearly?
It is important not to assume that the person who discovers the problem is necessarily the person who caused it. A restoration may be returned because of an occlusal discrepancy, but the underlying cause could involve the preparation, impression or scan, occlusal record, design, manufacturing process, finishing, clinical fitting or communication between the teams.
A useful investigation therefore separates evidence from assumption. Instead of recording “dentist took a bad impression”, the laboratory might record “returned due to marginal discrepancy; original impression reviewed and showed distortion in the relevant region”. The second record allows the evidence to be reviewed without prematurely assigning responsibility.
Patterns are particularly valuable. One remake may be an isolated event. A cluster of remakes involving the same material, furnace cycle, scanner, technician, clinical practice or type of case may indicate a process that needs review.
The aim is not to create a culture in which every mistake becomes a disciplinary issue. A healthy quality system makes it possible to identify problems early, investigate them fairly and improve the process. This is consistent with the GDC’s approach to complaints, which encourages analysis of complaints to improve the service and sharing lessons learned with the team.
6. Traceability, Confidentiality and the Record That Remains
Good records need to be useful without becoming excessive. A laboratory may hold prescriptions, work tickets, photographs, scans, design files, material information, correspondence, quality-control records and complaint documentation. Together, these records can provide a detailed history of how a device was manufactured.
For custom-made medical devices, manufacturers have regulatory responsibilities concerning documentation and traceability. Current MHRA guidance states that manufacturers must retain documentation that allows the design, manufacture and performance of a device to be understood and assessed for conformity. The precise documentation and retention requirements depend on the type and classification of the device.
Traceability is particularly important when a problem is identified with a material, component or manufacturing process. The laboratory should be able to identify which cases may have been affected and take appropriate action through its quality and post-market surveillance procedures.
However, traceability must be balanced with confidentiality. GDC Principle 4 requires dental professionals to protect patients’ information and ensure that records are stored securely. Patient information should only be accessed or shared for appropriate purposes and according to applicable legal and organisational requirements.
This is especially relevant to digital laboratories. STL files, photographs, screenshots, design files, emails and messaging applications can all contain information capable of identifying a patient or case. Moving information between personal devices, informal messaging platforms or unsecured storage can create risks that would not exist with a properly controlled laboratory system.
A good laboratory therefore needs more than a filing cabinet full of old work tickets. It needs a coherent record-management process: appropriate information is recorded, significant changes are traceable, complaints and quality events can be reviewed, records are securely stored, and retention and disposal are managed according to the laboratory’s legal and organisational requirements.
Ultimately, good record keeping is not about preparing for a legal dispute. It is about making good professional practice visible. A clear record allows the laboratory to communicate effectively, investigate problems, learn from mistakes and demonstrate how decisions were made.