To paraphrase E.B. Clark: In general, dentists are not educationally equipped to solve color problems. When we talk about color science in dentistry the question is: What is success? Success is simply that one restoration matches the other. At the end of the day, our patients aren't dentists; all they want to know is whether the restorations match or not.
An unpublished survey of 10,000 dentists shows that the vast majority of restorations coming back to the lab for remake do so because of color. When dentists were asked what is the common cause of mismatch, it was either too light or too dark.
The top 10 problems with shade selection:
- Poor quality lighting.
- Using non-evidenced-based shade guides. (Classic is subjective versus 3D, which is objective.)
- Taking too long to select the shade. (We're physiologically programmed that if we stall or stare too long, it will cause errors in our judgment.)
- Mixing and matching restorative materials. (If we don't understand the reduction requirements for the materials that we're selecting it will cause failure.)
- Not using photography. (Photography is critical not only for patient education and treatment planning, but also for communication to our laboratory.)
- Taking shades at the end of the appointment. (This is a big problem; our eyes are tired; the patient’s teeth are dehydrated, etc.)
- Not using optoelectric devices.
- Oversaturated backgrounds. (What's going on in the background is going to significantly impact what you're looking at when selecting a shade. If you're using pastel colored bibs or if your chair is burnt orange, it can really impact shade selection.)
- Using old shade guides (With today's infection control, we disinfect our shade guides. Over time, we're actually stripping of the glaze layer off of the shade guide so what you're using in your office doesn't match what your technician has.)
- Using a single modality. (This is the most important thing. Simply using just one modality is going to get you into trouble.)
In the end, we're trying to get rid of subjectivity and eliminate the optical illusions.
Can you think of any other problems with shade selection that haven't been covered here? Let us know in the comments area below.