Tooth color is complex. There are colors on the surface of the tooth and colors within the tooth. The enamel itself is fairly translucent and it imparts a little color. The dentin is not as translucent and imparts more color, but it also transmits light. The surface texture of a tooth also has a strong impact on the perceived color. Shiny highlights can make a tooth appear brighter than it is.
Some of the strongest complaints I get from cosmetic dentistry patients who email me is that their dentist didn’t get the color of the tooth right. For many dentists, this is definitely a weak spot. A little about this subject is taught in dental school, but for a dentist to really understand it requires special courses, a strong desire to improve his or her esthetic skills, and a certain amount of natural aptitude. A good cosmetic dentist needs to master this subject.
The basic parameters of color are hue, saturation, and luminence. The dentist needs to add to this an expert understanding of translucency, reflectivity, and transmission. It isn’t an easy subject.
A Typical Example of a Tooth Color Mistake
A key skill for an expert cosmetic dentist is to understand and use tooth color correctly. The photo below illustrates the problems many dentists have with color.
This case comes from Nashville cosmetic dentist Dr. Thomas Nabors. Click each photo to see an enlarged version
The crown on our left in the left-hand picture is approximately the correct color, but it lacks all of the subtleties and refinements that make it look real. Notice how it lacks depth. It also has one uniform color at the base of the crown that gradually changes as you get closer to the biting edge.
The crowns in the right-hand picture, on the other hand, have a much more complex color structure. We have the illusion of depth, and there are a number of slight variations in the color throughout the teeth, similar to what we see in the adjacent natural teeth. Even as an expert cosmetic dentist, I would not be able to tell that these are not two natural teeth without seeing the before photo.