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Color and Shade Matching in Dentistry

Article  in  Trends in Biomaterials and Artificial Organs · September 2011

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Trends Biomater. Artif. Organs, 25(4), 172-175 (2011) http://www.sbaoi.org

Review Article

Color and Shade Matching in Dentistry

Mohammed Shammas*, Rama Krishna Alla
Faculty of Dentistry, Al-Fateh University of Medical Sciences, Tripoli, Libya
*Corresponding author: (shammasm@rediffmail.com) Dr. Mohammed Shammas

Received 18 July 2011; Accepted 18 August 2011; Available online 8 September 2011

A thing that is not understood often becomes the focus of mystery, fear, indifference or abject rejection. Color, although a part
of nearly every human activity is one of those things that is poorly understood and shrouded by misconceptions. Much of the
scientific literature on color is riddled with mathematical formulae, which, useful in a technical or industrial laboratory, have
little meaning to everyday situations. The dental literature usually reports results of the particular aspect of color under scrutiny,
without discussing fundamental principles. The aim of this article is to ‘open the doors of perception’ so that the entire dental
team can comprehend and use color in daily practice.

Introduction and therefore called the “invisible” spectrum. Together,

An understanding of the nature of light and how the eye
perceives and the brain interprets light as color is
important for successful esthetic restorations, particularly
when metal-ceramic or all-ceramic restorations are being
made [1].
Nature of Light
Electromagnetic waves are everywhere and light is only
a small part of them. Light is basically photons and mostly
moves as waves. White light that is seen by human eye
is called as “visible” light (380 nm to 780 nm) [2]. Waves
called radio, microwave, infrared, ultraviolet (UV), x-
rays, and gamma rays cannot be seen by the human eye,
the visible and invisible spectrums make up the
electromagnetic spectrum (Fig 1).
The light is not really white; the white we see is a
combination of all the colors of the rainbow - Red-
Orange-Yellow-Green-Blue-Indigo-Violet. When white
light is made to pass through a crystal prism, as was done
by Sir Issac Newton in 1676, it is bent, and each
wavelength changes direction by a different amount and
the individual colors of the visible spectrum are seen
[3]. There are three things that can happen to a light wave.
It can be reflected, absorbed, or transmitted. If all of the
light is reflected, the object appears white. If the light is
entirely absorbed, the object appears black.
Color
Color is a property of light. Objects have no color of
their own; they just reflect a particular wavelength from
the color spectrum. For example a blue object absorbs
all of the wavelengths, except for blue. The remaining
wavelengths enter our eyes and this is what we see.
Description of Color

The most popular method for describing color is the

Munsell system. The three attributes of color in this
system are called Hue, Chroma and Value.
Hue: It is defined as the particular variety of a color. The
Figure 1: Electromagnetic spectrum Hue of an object can be red, green, yellow, and so on.
172
 Color and Shade Matching in Dentistry
Chroma: The intensity or saturation of a hue is called
Chroma.
Value: The relative darkness or lightness of a color is
called Value.
There are two types of color, additive and subtractive [4].
Additive Color: These are the color obtained by emitted
light and are associated with television and computer
displays. The primary additive colors are Red, Blue and
Green and the secondary additive colors are Cyan, Yellow
and Magenta. When additive primary colors are combined
they produce White.
Subtractive Color: These are the colors associated with
reflected light and are used in pigments for making paints,
inks, fabrics etc. The primary subtractive colors are Red,
Yellow, and Blue and the secondary subtractive colors
are Green, Violet and Orange. When subtractive primary
colors are combined they produce Black.
Color Perception
Eyes can’t see alone. Our eyes and brain have to work
together to make a sense of light and color. Light goes
through the pupil and splashes on the rods and cones of
the retina. There, the light causes a chemical reaction.
The optic nerve connects eyes to the brain. It understands
the chemical reaction and carries a message to the brain.
There the color perception takes place.
Eyes: The initial process occurs in the retina of the eye.
The retina contains millions of cells called photoreceptors
that are sensitive to light. There are two types of
photoreceptors, some shaped like rods and some like
cones. These photoreceptors process light into nerve
impulses and pass them along to the cortex of the brain
via the optic nerve. 120 million RODS in the outer edges
of the retina help eyes adjust when one enters a dark room.
They are good for detecting motion and for seeing in low
light-levels. At low light levels, the rods of the human
eye are more dominant than the cones and color
perception is lost. As the brightness becomes more
intense, color appears to change (BEZOLD-BRUCKE
EFFECT) [5]. There are 6 million CONES in each eyeball
which are sensitive to colour. There are three types of
cone cells, each sensitive to the long, medium or short
wavelength of light (red, blue and green color
respectively).
Color Blindness
Color blindness is the inability to distinguish the
differences between certain colors. This condition results
from an absence of color-sensitive pigment in the cone
cells of the retina. Humans are born color blind because
the cones do not begin functioning until a baby is about
four months old. One male in twenty suffers from some
form of color blindness, but only one in several hundred
females are color blind. Color blindness is usually
inherited, that is, a genetic defect. Not all color deficiency
is due to heredity. Aging, certain medications, and retinal
or optic nerve disease may interfere with normal color
vision.
Shade Selection
Quality of Light: Energy distribution of a light has definite
effects on the type of color being perceived. The clinician
should try and use a source of light that contains full
spectrum of rays without the dominance of any
wavelength; because when an object is viewed under
lights dominating in particular wavelengths (color bands),
that specific color becomes dominant to the observer.
There are three types of light sources [1]:
1. Incandescent Light: Emits high concentration of yellow
waves. It is not suitable for shade matching. It has low
Color Rendering Index (CRI).
2. Fluorescent Light: Emits high concentration of blue
waves. It is not suitable for shade matching. It has CRI of
50-80.
3. Natural Daylight: Northern daylight is considered the
best because it is closest to emitting the full spectrum of
white light. It is used as the standard by which to judge
other light sources. It has CRI close to 100.
Most dental offices are fitted with incandescent and
fluorescent lights [1].
Color Rendering Index: Northern daylight, which can be
close to full-spectrum white light and often, is used as
the “normal” standard for judging light from other
sources. It has a color rendering index (CRI) close to 100.
The color rendering index, on a scale of 1 to 100, indicates
how well a particular light source renders color as
compared to a specific standard source.
Another light source reference standard is color
temperature, which is related to the color of a standard
black body when heated. Color temperature is reported
in degrees Kelvin (K), or absolute (0°° K = -273°° C).
Northern daylight has an average color temperature of
around 6500°°K, but this varies with the time of day, cloud
cover, humidity, and pollution.
Although daylight is often used as the standard against
which other light sources are compared, never use direct
sunlight to take tooth shade. The distribution of light
waves from the sun depends on the time of day and on
humidity and pollution. Morning and evening incident
light has shortened blue and green waves scattered and
only the longer waves penetrate the atmosphere. Therefore
daylight at dawn and dusk is rich in yellow and orange
but is lacking in blues and greens. Northern daylight
around the noon hour on a bright day is considered ideal,
because the incident daylight is most balanced within the
Visible Light Spectrum.
Metamerism: Another aspect of lighting is the subject of
metamerism. Two objects may appear to be identical
173
 M. Shammas, R.K. Alla
colors under a certain kind of light, yet under another
kind of light they may appear totally different. This is
called metamerism. The problem of metamerism can be
avoided by selecting a shade and confirming it under
different lighting conditions (e.g., natural daylight and
fluorescent light).
Key optical properties of teeth [6]
1. Fluorescence is the absorption of light by a material
and the spontaneous emission of light in a longer
wavelength. Teeth are fluorescent because they emit
visible light when exposed to Ultra-Violet light.
2. Opalescence is the ability of a translucent material to
appear blue in reflected light and red-orange in transmitted
light. The opalescent effect is based on the behavior of
translucency of natural teeth.
3. Translucency is transmission and diffusion of light
through an object so that definite image beyond the object
cannot be seen.
Guidelines for Shade Selection
1. Teeth to be matched should be cleaned of all debris
and stains. Prophylaxis should be done before shade
selection.
2. Brightly colored lipstick/makeup should be removed7
(strong red lipstick next to the tooth will fatigue the red
receptors while the blue and green receptors remain fresh
and fully stimulated. This makes the tooth that looks blue-
green) and bright clothing should be draped with gray
napkin. The operatory walls should be painted gray.
Figure 2: Colour wheel
174
3. Patient should be viewed at eye level and at arms length,
so the most sensitive part of the retina will be used [7].
4. Shade comparisons should be made under different
lighting conditions. Initial shade may be taken under a
color corrected fluorescent light and then confirmed in
natural daylight (taking patient to an operatory window).
5. Shade comparisons should be made at the beginning
of a patient’s visit. Teeth increase in value when they are
dry because of desiccation.
6. Shade comparisons should be made quickly (5
seconds), with shade tabs placed just under the lip and
adjacent to the teeth to be matched.
Hue sensitivity: After 5 seconds of staring at a tooth or a
shade guide, the eye accommodates and becomes biased.
If one stares at any color for longer than 5 seconds and
then stares away at a white surface, or closes one’s eyes,
the image appears, but in the complementary (color
opposite to each other in a color wheel) ( Fig.2) hue. This
phenomenon is known as hue sensitivity which badly
effects shade selection.
7. Look at a gray walls or patient’s napkin between each
shade evaluation.
Types of shade guide [8]
The most popular shade guides currently used for dental
shade matching are:
- Vita Classic (Vita Zahnfabrik, Bad Sackingen, Germany)
- Vitapan 3D-Master (Vita Zahnfabrik, Bad Sackingen,
Germany)
- Chromascop (Ivoclar - Vivadent, Schaan, Liechtenstein)
- Custom or specific chroma and value guides
Vita Classic Shade Guide: It is a very popular shade guide
and has been in use since 1960’s [9]. Tabs of similar hue
are grouped into letter groups like:
A (hue of red-yellow) - A1, A2, A3, A3.5, A4
B (hue of yellow) - B1, B2, B3, B4
C (hue of gray) - C1, C2, C3, C4
D (hue of red-yellow-gray) - D2, D3, D4
Chroma is designated with numerical values 1, 2, 3 and
4.
Sequence for shade matching while using Vita
Classic shade guide
Step 1: Hue Selection
Operator should select hue closest to that of natural tooth.
Use area of tooth highest in chroma for hue selection.
 Color and Shade Matching in Dentistry

Step 2: Chroma Selection
Once the Hue selection has been made, for example B.
Chroma is selected from gradations within the B tabs -
B1, B2, B3, and B4. Several comparisons should be made.
Avoid retinal fatigue. Rest eyes between comparisons
(look at gray walls).
Step 3: Value Selection
Use of second, value oriented shade guide is
recommended.
Value oriented shade guide: B1, A1, B2, D2, A2, C1,
C2, D4, A3, D3, B3, A3.5, B4, C3, A4, C4,
Final value is selected by using a second shade guide
whose samples are arranged with light shade tabs first
and dark shade tabs last. Value is most easily determined
by observing the guide and teeth to be matched at a
distance, standing slightly away from the chair and
squinting. Squinting reduces the amount of light that
reaches the retina. Therefore stimulation of the cones is
reduced while rods become more sensitive to the
increasingly achromatic conditions. The dentist should
concentrate on which disappears first - the tooth or the
shade tab. The one the fades first has the lower value.
Step 4: Final Check / Revision
Following value selection, tabs selected for hue and
chroma may not coincide with shade tab selected for
value. If the Value of shade tab is lower than natural teeth
then select new shade tab with higher value because one
cannot increase value of restoration with extrinsic staining
because it will only increase opacity of the restoration. If
the Value of shade tab is higher than natural teeth then
select new shade tab with lower value or bridge the
difference with intrinsic or extrinsic staining.
Vitapan 3D-Master: In the early 1990s, Vita introduced
the 3D-Master shade guide with the aim of accurately
assessing shade according to the three components of
colour: hue, value and chroma. Unlike the majority of
dental shade guides, the 3D-Master attempts a three-
dimensional analysis of tooth color. The tabs are arranged
systematically and logically, rather than randomly as in
the Classic guide. The tabs are grouped into five
categories, sequentially numbered, with an increasing
value (1, 2, 3, 4 and 5). All tabs within a value group
have the same brightness. In a given value group, the
chroma increases from top to bottom. All groups, with
the exception of 1 and 5, are designated three letters, L,
M and R, corresponding to varying hue. For example 2M2
corresponds to the second value group, the M hue sub-
group and a 2-chroma level. For an intermediate tooth
shade, a combination of two tabs is used for the final
color prescription.
Chromascop: The Chromascop uses numbers to
distinguish hue, e.g., 100 (white), 200 (yellow), 300
(orange), 400 (grey) and 500 (brown). Chroma is
indicated by another set of numbers, 10 are high value
with low chroma, while 40 is low value with high chroma.
A conversion chart is available to convert Chromascop
shade tabs to the Vita Classic shades.
Custom guides: Finally, if the tooth color fails to concur
with any of the shade guide tabs, porcelains can be used
to fabricate a custom shade tab. If extremes of value and
chroma are required, specific detailed chroma and value
guides are available. These may be necessary with aged
teeth of deep chroma, or youthful teeth with high values.
Conclusion
An understanding of the science of color and color
perception is crucial to the success in the ever expanding
field of esthetic restorative dentistry. Limitations in
materials and techniques may make a perfect shade
selection impossible. Shade selection should be
approached in a methodical and organized manner. This
(a)
will enable the practitioner to make the best choice and
communicate it accurately to the laboratory.

References
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selection, 3rd edition. Mosby, St Louis, Chicago, p.592-608 (1995).
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Quintessence publishing co. inc. Chicago, p.17-24, (1993).
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edition, Quintessence publishing co. inc. Chicago, p.145-170 (1992).
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