Shade communication with your dental lab: photos, stump shades and what technicians need

A shade code tells the lab one thing about a tooth. A technician matching a front tooth needs at least four.

They need the shade and the guide it came from, photos with the tab in the frame, the colour of the prepared tooth, and a description of what a code cannot say.

This guide covers each of those, in the order they happen at the chair.

Four things a technician needs to match a front tooth

A flow of four steps at the chair, in order: take the shade and note the guide, send photos with the tab in the frame, give the stump shade, and describe what a code cannot say.

1. 1

   The shade and its guide

   Taken first, before the tooth dries out.

2. 2

   Photos with the tab

   Edge to edge with the tooth, with the code visible.

3. 3

   The stump shade

   The colour of the tooth after preparation.

4. 4

   What a code cannot say

   A shade map in three bands, and the features to copy.

Why one code is not enough

A natural tooth changes colour from the gum line to the edge. It is often warmer near the gum and more translucent at the tip.

It also has features. White flecks, fine lines, a bluish edge and a certain surface gloss are all part of how it looks.

A single code describes the middle of the tooth, roughly. Everything else has to reach the lab another way.

The technician has never seen this patient. They have only what you send.

Dr. Joel Gaudet, the dentist who founded Tusko, mills same-day crowns in his practice and still sends front teeth to a lab:

“For any front tooth I still want a lab doing custom shading, because a tooth isn’t one colour. It’s a bunch of different shades and hues.”

Dr. Joel Gaudet, Wave Dentistry

Take the shade first

Take the shade at the start of the appointment. A tooth dries out while it is being worked on, and a dry tooth looks lighter and chalkier.

Set the scene before you hold up a tab.

• Ask the patient to remove bright lipstick, and cover a strongly coloured top with a neutral bib.
• Use daylight or a colour-corrected light, and switch off the operatory lamp.
• Hold the tab beside the tooth at the same angle, so both catch the light the same way.
• Decide within a few seconds, then rest your eyes on something neutral grey and look again.
• Check how light or dark the tooth is first, then how strong the colour is.

Write down the shade and the name of the shade guide. The same code is a different colour on a different guide.

Ask a second person to look as well. If the two of you disagree, note both shades and let the photos settle it.

If the patient plans to whiten their teeth, do that first. Take the shade once the colour has settled, which the dentist judges.

Send photos the lab can read

A good photo carries more than any note. Four pictures cover most cases.

1. The tooth with the chosen tab. The tab sits edge to edge with the tooth, in the same plane, with the code visible.
2. The same view with a second tab. One step lighter or darker gives the technician a scale.
3. A wider view of the smile. The neighbours show what the new tooth has to sit beside.
4. The prepared tooth with a stump tab. This is the stump shade, covered below.

A few habits make each one usable.

• Retract the lips and cheeks so nothing shades the teeth.
• Angle the camera slightly, so the flash does not bounce straight back as a white patch.
• Keep the teeth moist. Take the photo before the tooth has dried.
• Do not edit or filter the picture. The lab needs what the camera saw.

Camera or phone

A dental camera with its own flash gives the most consistent colour. A phone can work if you use the same phone, the same light and no filter every time.

Tell the lab which you used. A technician learns how one practice’s pictures run, warm or cool, and allows for it.

How to photograph a case for your dental lab covers cameras, settings and phone photos.

Give the stump shade

A stump shade is the colour of the tooth after preparation. It matters whenever light can pass through the restoration.

A translucent ceramic over a dark tooth looks grey. A technician who knows the stump is dark can use a more opaque material to hide it.

Take it with a guide made for prepared teeth, and photograph the tab beside the preparation.

For an opaque restoration it matters less. If you are unsure how translucent the material is, send it anyway.

Mention anything unusual under the crown. A metal post or a dark core changes what the technician has to hide, and a photo shows it best.

Describe what a code cannot say

A short shade map closes the gap. Divide the tooth into three bands and give each a shade.

Then list the features to copy.

• White or brown spots, and where they sit
• Fine vertical lines
• How glossy or textured the surface is
• Any worn or chipped edge the patient wants kept or corrected

“Match tooth 21” is a fair instruction for a crown on tooth 11. It only works with a clear photo of 21 to match.

Say what the patient wants, too. Some want the new tooth to blend in exactly, and some want it a little brighter.

Pink ceramics

Some restorations replace gum as well as tooth. The pink has a shade of its own, called the gingival shade.

Treat it the way you treat tooth shade. Use a gum shade guide, and photograph the tab against the patient’s own tissue.

Know when to send the patient

Some matches are too fine for photos. A single central incisor beside a natural one is the usual example.

A custom shade appointment puts the patient in front of the ceramist. They see the tooth wet, in their own light, from every angle.

It adds a trip for the patient and time for the lab. It can save a second try at the crown.

Ask your lab how it handles these visits, what it charges, and how to book one.

Tell the patient what the visit is for. They should arrive without lipstick, and with time to wait.

Close the loop after the seat

Tell the lab how the shade turned out, every time. A photo of the seated crown is feedback a technician can use straight away.

If it was slightly off, say how: too light, too grey, too opaque. That is what improves the next one.

If it was right, say that too. The lab should know which of its choices worked.

Keep the photos you sent with the patient’s record. If the tooth ever needs replacing, the next technician can start from them.

How to give your dental lab feedback covers how to do this without it turning into blame.

Keep the shade with the case

Shade details get lost when they travel apart. The code is on the Rx, the photos are in an email, and the map was said over the phone.

Put them in one place. Our dental lab prescription checklist lists the shade fields a complete Rx carries.

On Tusko, the photos sit on the case beside the Rx and the scans. If the lab needs another picture, it asks there, and the reply lands in the same place.

See how it looks for practices and for labs.