With more and more dentists promoting cosmetic dentistry and the patients increasing desire to have restorations that are indistinguishable from their natural teeth, it is critical that a dentist be able to correctly evaluate tooth shade information and properly convey it to the ceramist at the dental lab. This can be tricky because it is as much of an art as it is a science.
Problematic issues may occur from a dentist not taking enough time or not having the right equipment / technology to color match. Patients pay a lot of money these days for their new smile and they should get the best result possible. It can be helpful to have more than one set of eyes around since people see things differently and the perfect match is the ultimate goal.
Most dentists remember the days when simply writing “A3” in a box on a lab sheet was good enough. After all, the lab should be able to figure it out right? Unfortunately teeth are not identical to the VITA shade guide tabs. They are much more complex since dentin and enamel have many characteristics, so if we are trying to achieve more accuracy it would be good to put a little more effort into the process.
It may seem overwhelming, but you don’t need to be an expert in art to take a good shade.
Here are a few suggested steps for good shade communication between you and your dental lab:
- Take a photograph – Sending photographs is one of the best ways to communicate the shade to the lab. If at all possible, purchase a digital SLR camera with flash and macro lens. Getting a professional camera will take you to another level of accuracy and improve your dentistry.
- Pick out more than one shade tab. More than likely there will be more than one shade tab that looks good. This will allow the lab technician more insight and the chance to compare elements of color between the two pictures. It is very important to include a stump shade (color of the prepared tooth) if you are prescribing an all ceramic restoration.
- Use proper technique when taking the photograph. Always make sure the shade tab and lettering is completely visible (A2, D3 etc.). It is also critical that you hold the shade tab at the same angle and orientation as the natural teeth so that the light reflects off it the same way. Try to place the shade tab in an incisal edge to incisal edge position. Also the shade should be taken as quickly as possible to eliminate retinal fatigue.
- Don’t forget the details. When replicating natural teeth, there is more than just shade involved. There is also characterization and texture, how the shade is distributed throughout the tooth, as well as any micro details such as indents or bumps on the surface of the tooth. Although this can be conveyed through detailed drawings, it is best to get an extreme close up which can only be done with a camera that has a proper macro lens. This picture should be separate from your shade tab photos.
As you can see, being able to take an accurate shade is very important. The shade prescribed will be favorable or detrimental to the final outcome of the restoration. Shade analysis can be both challenging and fun, but most of all it is a necessity in this day and age of cosmetic dentistry.
*** There are also digital shade matching devices that simplify the process even more. Image Dental Arts advocates the Easyshade by Vita. If you have any questions about shading please give us a call at 260-496-8800.