Japanese dental technicians take govt to court / Ban demanded on foreign-made dentures claimed to put health of patients at risk

A group of dental technicians has filed a lawsuit against the government, demanding state legislation banning the making of false teeth being outsourced overseas.

Only dentists or dental technicians are permitted to make false teeth domestically, but there are no such regulations regarding false teeth made abroad. Although they can be made much more cheaply overseas, there are concerns the dentures or crowns might contain materials that pose health risks.

The government has so far been content to remain at arm's length over the matter. "If dentists judge [the false teeth] to be safe, then they're free to import them," a government official said.

The plaintiffs, a group of 81 technicians from across the country, strongly oppose the government's stance and filed their lawsuit at the Tokyo District Court.

"Uncertified practitioners are making false teeth. If the matter isn't addressed, we are concerned people's health might be affected," a spokesman for the plaintiffs said.

Dentures and crowns are used to fill gaps in chipped or missing teeth. Normally, a dentist instructs a technician to make each false tooth individually to ensure a perfect fit.

Dental technicians in Japan are certified by the state. Uncertified personnel are not permitted to make false teeth under a law that regulates the duties and certification of the nation's 35,000 dental technicians. Violation of this law carries a maximum prison term of one year.

According to the petition and other sources, imported false teeth, mainly from China, are being used by dental clinics here.

A number of companies that relay dentists' instructions to workshops in China before importing the completed false teeth have emerged in recent years.

Although not covered by health insurance, imported false teeth cost between about one-half and one-third of those made in Japan.

Intensifying competition between dentists in recent years is believed to have spurred efforts to cut costs.

In a survey conducted in July by Hodanren, a national federation of associations of doctors who accept health insurance patients, 130 of the 2,008 dental clinics nationwide answered that they "had placed orders overseas."

"The strict regulations on the making of false teeth are necessary to ensure the safety of these items that are put into people's mouths," the plaintiffs state in the lawsuit. "Overseas, uncertified practitioners might use any material they like to make [false teeth]. This contradicts the purpose of the law."

A spokesman of the Health, Labor and Welfare Ministry's Dental Health Division said: "Dentists are responsible for making judgments on safety issues. No specific cases have come to light showing that false teeth made overseas are dangerous."

However, the ministry stated in 2005 that it did not know precisely what materials were being used to make false teeth overseas. It instructed dentists to explain to patients what materials were contained in the false teeth and to only provide such teeth with a patient's assent.

The ministry plans to establish a panel to examine the issue of foreign-made false teeth before the end of the fiscal year.

Yukio Wakimoto, a representative of the plaintiffs, expressed dissatisfaction at the ministry's tardy response.

"Why do we have state certification for dental technicians?" asked Wakimoto, a 66-year-old dental technician. "The horse will have bolted if they only do something after the danger to patients has become clear."

Not all dentists and technicians, however, oppose using false teeth made in China.

Tetsuro Shinoda, a dentist from Nagoya, has been importing false teeth from a workshop in Guangdong Province, China, since 2005. He has contracted out the making of hundreds of false teeth, and tells his patients their dentures are made in China.

"Even though they're made in China, the materials come from Europe and the United States, and so it's prejudicial to say they're inferior items," Shinoda, 51, said. "Their quality is on a par with false teeth made by skilled Japanese technicians."

But Shinoda also sympathized with the plaintiffs' plight.

"It's likely that some workshops in China churn out shoddy items. The government needs to use the trial as an opportunity to create some kind of regulations," he said.

The court will rule on the suit on Sept. 26.
(Sep. 7, 2008)

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