April 16, 2014

Tooth Shade or Color

dental shade guide

Bleaching shade guide on left and traditional natural tooth shade guide on right

teeth after bleaching

Judy with great results bleaching her teeth to a BL3 shade.

Tooth Shade Guide

Color is one of the most important decision that concerns the cosmetic dentist and patient.  Historically dentists would utilize the classic VitaPan tooth shade guide, with the 16 most common colors found in natural teeth.  However, with the introduction of bleaching into mainstream dentistry two decades ago, which oftentimes produced teeth lighter than the traditional VitaPan tooth shade guide, patients and dentists demanded that new whiter porcelains be produced to correspond to the colors that patients were achieving.  The bleaching shade guide on the left is the new bleaching shade guide (the original names for the bleaching shades were 010, 020, 030 and 040, which have since been replaced with BL1, BL2,Bl3 and BL4, “BL” referring to “bleaching”).

color teeth smile makeover with porcelain veneers or crowns

Different shades patients have chosen for their smile makeover with porcelain veneers or porcelain crowns. Two on top left wanted more natural colored teeth. Three on bottom right wanted more bright, white, "Hollywood"style.

Click on categories Tooth Color to see numerous examples of different tooth shade colors.

Change in tooth shade preference in the past few decades

As a cosmetic dentist with over three decades of experience, we’ve noted a huge shift in the colors we’re using for our cosmetic cases.  Back in the 1970s and 1980s “A2″ was the most popular shade when doing cosmetic dentistry on multiple teeth.  When porcelain veneers were introduced to dentistry in 1985 and the public started becoming more cosmetically focused, “A1″ was the most popular color.  Then by the year 2000 “B1″ became the favorite.  In the last two years we’ve found that in our cosmetic dental practice the most commonly requested shade was “BL2″ by 50% of our patients, and “BL1″ by 40% of our patients.

cosmetic dentistry with two distinctly different color teeth

Rosemary shows 12 teeth when she smiles,wanted whiter teeth but chose to only have porcelain veneers placed on 8 teeth. This isn't much noticeable in normal conversation, but the color difference does become apparent when she smiles.

How many porcelain veneers or porcelain crowns need to be done?

A question that many patients have is how many porcelain veneers or porcelain crowns do they need? The answer usually depends on two things, how many teeth they show when smiling and how white they want their new teeth to be. If there is a noticeable difference between the color of their other visible natural teeth and the color they want for their new teeth, then 8-10 veneers or crowns may be necessary to avoid showing the unnatural appearance of two distinctly difference tooth colors.

very dark teeth treated with upper porcelain veneers and lower teeth bleaching

Evelyn grew up in Texas where the high mineral content in the water caused a permanent blackish discoloration of her teeth. She was successfully treated by placing porcelain veneers on her upper teeth and bleaching her lower teeth.

Whether or not to do lower porcelain veneers or lower porcelain crowns?

Another question of concern is if whiter porcelain veneers or porcelain crowns are placed on the upper teeth, whether or not the lower teeth will have to have them as well?  Typically the upper teeth show more when smiling, and the lower teeth more when speaking, especially when angry.  Another point is that since the lower teeth are set back more and are less visible than upper teeth they are generally shadowed and don’t quite broadcast that fact as much if they haven’t been treated with porcelain veneers.

We’ve found among thousands of porcelain veneers or porcelain crowns that we’ve placed that 2/3 of our patients are content with doing porcelain veneers/crowns on their upper teeth and just bleaching their lower teeth, while the other 1/3 want more perfection and have us place porcelain veneers or porcelain crowns placed on their lower teeth to match their upper.  The the lower porcelain veneers or porcelain crowns don’t have to be done the same time as the upper porcelain veneers or porcelain crowns.  They can be done immediately after or even years later.

Dr. Norman Huefner, Orange County Cosmetic Dentistry and Porcelain Veneers. Serving the surrounding cities of Laguna Niguel, Irvine, Newport Beach, Mission Viejo and Rancho Santa Margarita
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