Job Descriptions, Definitions Roles, Responsibility: Medical, Dental, and Ophthalmic Laboratory Technicians

When patients require a special appliance to see clearly, chew and speak well, or walk, their health care providers send requests to medical, dental, and ophthalmic laboratory technicians. These technicians produce a wide variety of appliances to help patients.

Medical appliance technicians construct, fit, maintain, and repair braces, artificial limbs, joints, arch supports, and other surgical and medical appliances. They read prescriptions or detailed information from orthotists, podiatrists, or prosthetists. Orthotists treat patients who need braces, supports, or corrective shoes. podiatrists are doctors who treat foot problems and request the same appliances as orthotists. Prosthetists work with patients who need a replacement limb, such as an arm, leg, hand, or foot, due to a birth defect or an accident. The appliances are called orthoses and prostheses. Medical appliance technicians are also referred to as orthotic and prosthetic technicians.

For orthoses such as arch supports, technicians first make a wax or plastic impression of the patient’s foot. Then they bend and form a material so that it conforms to prescribed contours required to fabricate structural components. If a support is mainly required to correct the balance of a patient with legs of different lengths, a rigid material is used. If the support is primarily intended to protect those with arthritic or diabetic feet, a soft material is used. Supports and braces are polished with grinding and buffing wheels. Technicians may cover arch supports with felt to make them more comfortable.

For prostheses, technicians construct or receive a plaster cast of the patient’s limb to use as a pattern. Then, they lay out parts and use precision measuring instruments to measure them. Technicians may use wood, plastic, metal, or other material for the parts of the artificial limb. Next, they carve, cut, or grind the material using hand or power tools. Then, they drill holes for rivets and glue, rivet, or weld the parts together. They are able to do very precise work using common tools. Next, technicians use grinding and buffing wheels to smooth and polish artificial limbs. Lastly, they may cover or pad the limbs with rubber, leather, felt, plastic, or another material. Also, technicians may mix pigments according to formulas to match the patient’s skin color and apply the mixture to the artificial limb.

After fabrication, medical appliance technicians test devices for proper alignment, movement, and biomechanical stability using meters and alignment fixtures. They also may fit the appliance on the patient and adjust them as necessary. Over time the appliance will wear down, so technicians must repair and maintain the device. They also may service and repair the machinery used for the fabrication of orthotic and prosthetic devices.

Dental laboratory technicians fill prescriptions from dentists for crowns, bridges, dentures, and other dental prosthetics. First, dentists send a specification of the item to be manufactured, along with an impression (mold) of the patient’s mouth or teeth. Then, dental laboratory technicians, also called dental technicians, create a model of the patient’s mouth by pouring plaster into the impression and allowing it to set. Next, they place the model on an apparatus that mimics the bite and movement of the patient’s jaw. The model serves as the basis of the prosthetic device. Technicians examine the model, noting the size and shape of the adjacent teeth, as well as gaps within the gumline. Based upon these observations and the dentist’s specifications, technicians build and shape a wax tooth or teeth model, using small hand instruments called wax spatulas and wax carvers. They use this wax model to cast the metal framework for the prosthetic device.

After the wax tooth has been formed, dental technicians pour the cast and form the metal and, using small hand-held tools, prepare the surface to allow the metal and porcelain to bond. They then apply porcelain in layers, to arrive at the precise shape and color of a tooth. Technicians place the tooth in a porcelain furnace to bake the porcelain onto the metal framework, and then adjust the shape and color, with subsequent grinding and addition of porcelain to achieve a sealed finish. The final product is a nearly exact replica of the lost tooth or teeth.

In some laboratories, technicians perform all stages of the work, whereas, in other labs, each technician does only a few. Dental laboratory technicians can specialize in 1 of 5 areas: orthodontic appliances, crowns and bridges, complete dentures, partial dentures, or ceramics. Job titles can reflect specialization in these areas. For example, technicians who make porcelain and acrylic restorations are called dental ceramists.

Ophthalmic laboratory technicians—also known as manufacturing opticians, optical mechanics, or optical goods workers—make prescription eyeglass or contact lenses. Prescription lenses are curved in such a way that light is correctly focused onto the retina of the patient’s eye, improving his or her vision. Some ophthalmic laboratory technicians manufacture lenses for other optical instruments, such as telescopes and binoculars. Ophthalmic laboratory technicians cut, grind, edge, and finish lenses according to specifications provided by dispensing opticians, optometrists, or ophthalmologists and may insert lenses into frames to produce finished glasses. Although some lenses still are produced by hand, technicians are increasingly using automated equipment to make lenses.

Ophthalmic laboratory technicians should not be confused with workers in other vision care occupations. Ophthalmologists and optometrists are “eye doctors” who examine eyes, diagnose and treat vision problems, and prescribe corrective lenses. Ophthalmologists are physicians who perform eye surgery. Dispensing opticians, who also may do the work of ophthalmic laboratory technicians, help patients select frames and lenses, and adjust finished eyeglasses. (See the statement on physicians and surgeons, which includes ophthalmologists, as well as the statements on optometrists and opticians, dispensing, elsewhere in the Handbook.)

Ophthalmic laboratory technicians read prescription specifications, select standard glass or plastic lens blanks, and then mark them to indicate where the curves specified on the prescription should be ground. They place the lens in the lens grinder, set the dials for the prescribed curvature, and start the machine. After a minute or so, the lens is ready to be “finished” by a machine that rotates it against a fine abrasive, to grind it and smooth out rough edges. The lens is then placed in a polishing machine with an even finer abrasive, to polish it to a smooth, bright finish.

Next, the technician examines the lens through a lensometer, an instrument similar in shape to a microscope, to make sure that the degree and placement of the curve are correct. The technician then cuts the lenses and bevels the edges to fit the frame, dips each lens into dye if the prescription calls for tinted or coated lenses, polishes the edges, and assembles the lenses and frame parts into a finished pair of glasses.

In small laboratories, technicians usually handle every phase of the operation. In large ones, in which virtually every phase of the operation is automated, technicians may be responsible for operating computerized equipment. Technicians also inspect the final product for quality and accuracy.