Shade matching is a fundamental part of aesthetic dentistry, and mismatches are stressful. Here are my tips to ensure success:
1. Take the shade at the start of an appointment. Teeth lose moisture very fast (just three minutes) and as they do they increase in ‘value’ (become brighter).
2. Always take a shade using natural light, or artificial lighting that has been calibrated to 5500 Kelvin (daylight). Shades taken under artificial light, or light from a camera flash, will lead to a poor match because the light source may be too warm (orange) or too cold (blue).
3. Learn your composites. At undergraduate level, we are informed that A1 is A1, but that’s not always the case. Different companies use different formulations and one company’s A1 may not be the same as another’s. The use of custom shade tabs can help. Remember VITA shade guides are made from acrylic that is optically different from composite resin. Ensure you are using the shade guide from your composite kit and that this shade guide is actually made from the composite you are using.
4. Pick the correct value. As long as you have selected the correct value of material, you can often get away with a slight discrepancy in hue and chroma. Selecting a material that’s more translucent will lower the value and a more opaque material will increase it.
5. Bleach prior to anterior cosmetic work, whenever possible. Lighter teeth are easier to shade match than darker, complex discolourations. Remember to leave at least two weeks between completion of bleaching and shade taking, for the colour to stabilise as well as the quality of the bond.
6. Perfect your polish. A poorly polished anterior composite will look dull and lifeless, even if materials of the correct colour and translucency have been used. Increasing the polish will let light pass through, allowing for a more natural transmission from material to tooth.
7. Take your time. You don’t always need to go straight to the finish with anterior restorations. Ask your technician for a biscuit try in and you’ll receive back an unglazed restoration. This allows you a trial fit to check contour and value.
8. Keep it simple. Nine out of 10 posterior restorations can be restored with B1 for an enamel layer and the highest chroma dentine you have available: A4, A5, or the corresponding shade for your chosen brand.
9. Communication is key. When working with a lab, it’s important to communicate as much detail as possible to your technician. Perfect your photography, as a good picture says a thousand words. Photographs with and without contrasters show different details within the tooth; a black and white image of shade tabs next to the tooth is useful for selecting the correct value.
10. Be a perfectionist. If you aren’t happy with something, don’t fit it. If you review an anterior composite and it doesn’t look as good as you had hoped, redo it. You won’t always get things 100 per cent right the first time, but practice makes perfect.