Among the many improvements in dental care made during the past decade is one that dramatically improves the color of the teeth in a patient's smile.
"When a dentist is placing veneers or dental crowns on a patient's tooth, the dentist and patient work together to select a color that is appropriate for them," says Paul Landman, D.D.S., a general dentist who practices in Chicago's Loop. He treats a large number of patients who request cosmetic dentistry. "It seems as if it should be easy, but in fact, it can be a very tough job. Dentists constantly return veneers and crowns to their laboratories for color or shade changes because the expected result was not achieved."
In fact, Dr. Landman says that most problems occur due to miscommunications between the dentist and the laboratory. Yet, even when communication is good, some of the tools were not developed well enough so the desired color could be described to the laboratory technician. New imaging systems such as intraoral cameras and other dental equipment are being developed to digitize the color information from the tooth and will be able to transmit that color information using more sophisticated sensors that convey the appropriate shade of color to the laboratory.
"In the past, dentists had a shade tab that was held next to a tooth and if we came close to the shade of the patient's teeth, that was very good," explains Dr. Landman. "However, patients today are more savvy and they want a better color match. Today's shade guides are more sophisticated and feature more colors that better reflect the colors found in a natural tooth."
Although teeth appear white, he says, they contain many different colors that include shadings of yellow, red and brown. But if they don't look natural, they don't cut it.
"You don't want teeth that are too white that would stand out and look unnatural," says Dr. Landman. "Selecting the color of a single tooth restoration that has a natural tooth on either side is tough to match but restoring a row of several teeth is easier because they match each other. The dental office has to have appropriate lighting so that the best match can be made. Natural light or color corrected bulbs are best."
Dr. Landman understands the problems dentists and laboratory personnel have when trying to achieve the appropriate color and he explains some ways dentists can communicate the desired shade to the lab. For example, when he is matching teeth, Dr. Landman often will take a 35mm photograph with a shade tab next to the patient's natural tooth to the laboratory with the photo.
"This area is going to improve a lot in the future because technology will allow us to communicate the colors better," concludes Dr. Landman who concedes that many dentists who practice cosmetic dentistry expect perfect results the first time. "We've already made huge improvements, but I know that if we persevere, we can provide even closer matches in the future."
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