How to match tooth color

Matching Tooth Color

Patients desire esthetic and natural looking restorations. Therefore, dentists are always trying to match the color and characteristics of natural teeth. Here is the problem. While we can sometimes come close, it is impossible to perfectly match porcelain or white fillings (composite fillings consisting of acrylic and porcelain particles) with natural teeth. The material of natural teeth is very much different from that of restorative materials. Here are a couple of things to consider.

Because restorative materials like porcelain can not change color, it is important to bleach/whiten teeth prior to restorative work if there is any chance that you might like to whiten your teeth in the future.
The two upper front teeth should match. If someone needs a crown or veneer on one of the front teeth, I will let them know that it might be best to restore both front teeth in the same material so that they will be identical. That being said, when patients agree to this, I will often try to talk them out of it because I do not like altering beautiful, unrestored teeth. I just feel that it is important for patients to understand the situation and to be aware that the choice is to get close but leave one untouched ( The dentist should not be held responsible if the color is close but not exact), or restore both ( some patients will gladly choose this option ).
For patients who have a strong esthetic eye and wish to have cosmetically restored front teeth, I have always liked restoring the front two, front four, front eight or front ten. Notice that I did not say the front six. Very often the canine teeth which transition the front teeth to the back teeth will stick out a little bit more and if you restore these but not the next set or two, then it is possible that the canines which may now be even a little bit wider will block some of the light which would normally be illuminating the next teeth (the bicuspids). Once a decision to restore the canines has been made, I will usually suggest to restore every tooth visible in the smile line. ALL CASES ARE DIFFERENT AND YOUR DENTIST WILL ADVISE YOU ABOUT YOUR UNIQUE CASE.
Many labs use a surface stain: Often, there is a glaze brushed onto the porcelain before it goes into the glazing/firing oven. The thin glaze will be hard like porcelain and will be smooth and shiny. Sometimes a stain is incorporated into the glaze to add characteristics or to change part or all of the color of the restoration. The caution here is as follows. In time and with cleanings and eating, the surface glaze and stain may become thinner or may wear off entirely. If that were to happen, the core shade of the restoration would then show and this core shade may not be the desired shade. Modern glazes seem to be longer lasting than those in the past. My comfort level goes up when we can achieve the desired shade without the use of surface stains because I feel like the shade will be stable over time. Sometimes, surface shading is absolutely indicated.
There are many different shade guides and many different material manufacturers. This adds a whole other realm into shade selection. There are some newer electronic shade registering devices with which I have no experience. I know that paint shops have such devices but probably in a different form. The point is that at this time, shade selection is not as much of a science as it is an art. Oh, and having good luck never hurts.

Natural tooth color can vary in many ways:

Each tooth position can have a different look. The canine teeth are often the most color rich teeth and may appear slightly darker than the neighboring teeth. Normally, a tooth on one side of the mouth will be similar in color and characteristics to the tooth in the same position but on the opposite side of the mouth.
Each tooth can vary in color as you examine it from the gum-line to the biting edge. Many teeth will be slightly darker nearer the gum-line and become lighter as you get to the biting edge.
The translucency can vary: Translucency is the term used to describe light passing through something. If enamel is translucent on the surface, then light waves will enter the tooth and reflect back coming from different layers within the tooth giving a normal, lifelike appearance. Some natural teeth and some restorative materials are more opaque. Light will bounce off of the surface of these teeth so they will have a different look from teeth with translucent enamel. Some people prefer an opaque look with no color transition at all. We as dentists cannot really know what look patients are after. Often, we dentists will assume that patients might want what we consider to be natural color gradients. Because some public figures might have a very light and opaque color arrangement, it is understandable that people would find this attractive. Please use this page to open a dialogue with your dentist.
Translucent/gray incisal (biting) edges: If a tooth has translucent enamel and there is no underlying mid tooth material (dentin) in the incisal/biting edge of the thinner front teeth, then light will simply pass through the enamel and get lost in the mouth. The darkness of the mouth will have the effect of a gray biting edge. Not everyone has this but if they do, it would be nice to replicate this in any restorations when possible.
Lobing: If the inner core dentin has bumps or peaks toward the biting edge and this same tooth has a translucent covering of enamel, then the gray area will highlight the lobed or bumped dentin and this is called lobing.
Many teeth have enamel hyper or hypo calcifications (spots or areas with more or less minerals) which can appear like whitish or darker lines or spots. If all of the teeth exhibit this same kind of marking and a new restoration does not include this, then the new restoration might not appear as natural. This kind of color matching will sometimes be best achieved by the use of color correct photographs or a trip to the ceramist for them to get a look at your teeth.
There are other considerations about shade and characteristic selections but these are the major ones and your dentist can advise you and then the dentist will communicate your thoughts to the person making your restoration.

THE MORE EXACTING AND INTRICATE SHADE CHOICES BECOME RESULTS IN LABOR INTENSIVE COMMUNICATION AND FABRICATION. THERE IS ALSO INCREASED RISK THAT THE PATIENT WILL NOT BE SATISFIED WITH THE FIRST FABRICATION. THE AVERAGE COST OF THIS RISK COMBINED WITH THE COST OF THE INCREASED TIME OF COMMUNICATION AND FABRICATION SHOULD NOT BE BORN BY THE DENTIST. IN OTHER WORDS, IT IS REASONABLE FOR A DENTIST WITH ADVANCED SKILLS AT THIS LEVEL, USING A LAB THAT IS CAPABLE OF PRODUCING THE DESIRED RESULTS, TO HAVE FEES THAT MIGHT SEEM EXORBITANT. IT WOULD BE UNREASONABLE TO EXPECT THIS LEVEL OF WORK AT AN AVERAGE CROWN FEE. AT THE SAME TIME, MANY DENTISTS ARE ABLE OF ACHIEVING WORK THAT IS COSMETICALLY EXCELLENT IN THEIR NORMAL DAILY ROUTINE. I WOULD CONSIDER THEM A BARGAIN.

Restorative materials differ from type to type and manufacturer to manufacturer. This can affect both the strength and/or appearance of the restorations. Please see dental materials for more about this.