Gain Confidence in Your Whitening Results
by Proper Shade Taking
Rade D. Paravina, D.D.S., M.S., Ph.D.
12-Step Shade Taking Guidelines | More Information on Shade Taking
One of the biggest challenges in whitening is taking a true and proper shade in order to show your patients their real whitening shade achievements. Being consistent in your shade-taking technique will give you and your patient confidence in the recorded results. When performing tooth whitening on your patients, it is very important to properly document the shade changes that the patient's teeth undergo. The starting and ending shades should be documented in the patient's chart and recorded using a good quality camera. Having this documentation can be quite important as it is very difficult for patients to remember the original color of their teeth.
In order to accurately determine a tooth's shade, you should follow the guidelines listed below:
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Arrange the shade guide from the lightest to the darkest tab. For the Vita Classical, this order is:
B1/A1/B2/D2/A2/C1/C2/D4/A3/D3/B3/A3.5/B4/C3/A4/C4
For Vita Bleachedguide 3D-Master, use the actual manufacturer's order.
Use "daylight" color-corrected diffuse lighting, not the operatory light. The walls in the "shade taking" area of your office should be light gray.
Put a light gray bib on your patients, if possible.
Give your patient a mirror, so they can see what shade you are matching their tooth at. This will give them confidence in their results.
Ask your patient to remove any lipstick.
If a cheek retractor is used, a clear one is preferred.
Observe the tooth perpendicularly to its labial surface and align your eyes on the same level with the teeth. Shade matching distance should be 10-14 inches.
Whenever possible, place the shade tabs on the same plane and with the same relative edge position as compared to the tooth to be matched.
A single shade comparison should not be longer than five (5) seconds in order to avoid eye fatigue and minimize the tooth dehydration on the teeth, which can make the teeth appear whiter than they actually are.
Observe a light gray surface between two trials to correct your eye's ability to discern the shade differences. You can focus on the gray bib or wall.
When you find the matching shade for your patient's tooth that both you and the patient agree upon, use a high quality digital camera to take a photo of the tooth and matching shade aligned next to each other to keep in their record, so you can show them how many shades they've achieved when the procedure is done.
Take final shade matches for any restorative procedure at least two (2) weeks after completion of whitening to allow the color to stabilize.
If you are consistent in following these simple guidelines when taking shades for any whitening treatment, you might help ensure your patient's confidence in the end result of your work.
For more information on shade taking, please see: Paravina RD, Powers JM. Esthetic color training in dentistry. St. Louis: Elsevier; 2004.
Rade D. Paravina, D.D.S., M.S., Ph.D. is a graduate of the University of Nis, Serbia. He is currently Assistant Professor at the Department of Restorative Dentistry and Biomaterials at The University of Texas Dental Branch at Houston as well as Scientist at the Houston Biomaterial Research Center. Dr. Paravina is a member of the International Association for Dental Research, Project Leader for ISO 28642 (Dentistry-Dental Shade Conformity and Shade Interconvertibility), and a member of several other ISO and ADA standards committees. He has authored more than 100 scientific publications. He is editor/author of the book: Esthetic Color Training in Dentistry and author of color training software. Dr. Paravina has developed the scientific protocol for evaluating "chameleon effect" of dental materials, and designed Vita Bleachedguide 3D-Master (with Vita Zahnfabrik), the only shade guide developed specifically for tooth bleaching monitoring. Dr. Paravina lectures nationally and internationally on various topics associated with color and appearance in esthetic dentistry.
Dr. Paravina lives in Houston, Texas, with his wife, Ana, and his children, Dusan and Milica.
