The outsourcing of dental prostheses in Gauteng

This study examined the perceptions of South African dental laboratory owners, dental technicians and dentists so as to understand their opinions and experiences regarding the outsourcing of dental prostheses in the industry. The study explored the legislative position of the South African Dental Technicians Council (SADTC). In addition, the study sought the Dental Technicians Association of South Africa (DENTASA) opinion regarding legislation and outsourcing practices in the dental laboratory industry. This is a post-positivist qualitative study conducted in the interpretive paradigm. The study was conducted in Gauteng as this province has the greatest concentration of technicians and dentists. Simple random sampling was used to select participants for individual semi-structured interviews. Interviews were conducted with three different groups of participants – laboratory owners, technicians and dentists. In addition, a representative of the SADTC and DENTASA, respectively, was interviewed. The data collected from interviews was analysed using thematic content analysis. Findings generated from the study revealed that where dental laboratory services are outsourced, no formal contractual relationship exists between parties. Contracts are verbal. The study concluded that the dental technology industry does not operate within clearly defined legal frameworks when outsourcing. It was established that offshore outsourcing occurs infrequently, therefore having minimal impact on the industry and labour market. Technicians interviewed failed to see the potential negative influence that enhanced outsourcing volumes could have on the labour market. The study established that domestic outsourcing is widely practised and dental laboratories receive significant quantities of imported work. The study briefly considered medical device legislation as the South African dental technician industry is reported to be required to comply with the International Standard of Operation (ISO 13485) which will legislate medical device legislation. Dentists stated, confirming a widely held dental technology industry belief that they did not believe that they were sufficiently qualified to carry out laboratory procedures. The study revealed that technicians regularly consult with patients with the consent of dentists. This is, currently, an illegal practice. Disclosure of who is doing the laboratory work does not always occur. It was established that economic consideration was not a driver when respondents considered outsourcing offshore. Quality was considered a more important factor than price. The study found that that no legislation exists in South Africa that regulates the dental laboratory materials used. Therefore, the possibility of inferior material filtering the South African market is real and the need for a regulatory body is indicated. Technicians felt that there is no need to regulate outsourcing in South Africa. Dentists, on the other hand, were ambivalent. In conclusion, it is postulated that dental technology industry is in a developmental stage and there is a need for the industry to understand itself better. This research showed that the dental technology industry has an inexperienced understanding of business practices. A greater emphasis on producing a well rounded dental technician with the knowledge and understanding of general business concepts and practices which include legislation, regulations and ethics related to the industry is indicated.