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    Outside the box cosmetics for outside the guide results

    Exploring why shade matching is so challenging — and the products that can streamline the process.

    Our decision making  have been greatly enhanced by technology. 

    Technology in dentistry has provided for an incredible amount of efficiency and productivity in any office that chooses to embrace it. 

    However, despite all of the advances we’ve been fortunate to see in our profession over the last 20 years, there are still some things that we struggle with. One of these is proper shade taking — or perhaps a better way to phrase it is “proper shade discernment.” It seems that no matter how much effort we put into it, the correct answer is always just a little to the left or right.

    Trending article: What technology is right for your practice? 

    Over the years we, as a profession, have seen multiple attempts at solving this quandary through technology. However, the bottom line is this: We don’t have a technology readily available yet that takes the human eye and the human brain out of the equation. Because of that, we are often left with “getting it close” instead of “getting it right.”

    Real-world case from my office recently: A long-time patient with a beautiful smile comes in for routine re-care. As the hygienist is taking radiographs, the patient mentions that she has been having increasing sensitivity with tooth #7, and she thinks it is turning dark. When I hear this, I immediately think “No, no, no!”

    Why? Because we all know that one of the hardest things to do in dentistry is to match one single anterior tooth, especially in someone with an already gorgeous smile. The stress of doing, and sometimes re-doing, a case with high esthetic requirements is high. 

    Trending article: 5 surprising ways digital tools can boost your abilities

    In this case, the tooth had gone south without any kind of trauma. When the electric pulp tester registered no response from this tooth, I checked the periapical radiograph to ensure I could still see a pulp space. The good news was that I could, which meant that I could do the endo while keeping the access as conservative as possible. Since there were no previous restorations and I could create a small access, it allowed me to retain a near pristine clinical crown. This allowed for internal bleaching and restoring the access with a small composite. If the tooth ever darkens again in the future, it is a simple process to remove the composite and do internal bleaching again.

    However, not every potentially difficult cosmetic case can be solved this easily. The good news is that there are other ways that we can approach these cases that will help make the shade discernment process easier, less stressful and more accurate.


    Continue to page two for more...

    Dr. John Flucke
    Dr. John Flucke is in private practice in Lee’s Summit, Mo. He also serves as technology editor for Dental Products Report magazine and ...


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