Most of us offer patients the opportunity to bleach their teeth using in office or custom tray systems. On of the challenges associated with bleaching is properly evaluating the effectiveness using traditional shade guide systems. If your office is anything like mine, you have multiple shade guides within arms reach. Most likely these include the Vita Classic Shade Guide, a Bioform Shade Guide and several that came in kits of composite. So which one should you use to evaluate the effectiveness of tooth bleaching? The answer is none of them!
All traditional shade guides have some challenges as they relate to bleaching. The first and primary concern is that they lack a logical order from light to dark. Instead they are grouped by the hue or color family, so A’s on the left and D’s on the far right. When we evaluate bleaching we want the tabs arranged from lightest to darkest so that both the evaluator and the patient can easily see that the color of their teeth has moved to the left on the guide, or they are “lighter”. The tabs also lack a uniform color, and contain chroma gradient. this can be deceiving when trying to assess the effectiveness of bleaching. lastly, the lightest shade is not as light as we can bleach teeth, and therefore the sampling is incomplete.
The solution is to utilize the new Bleaching Shade Guide from Vita for bleaching evaluation. the shade guide is specifically designed to evaluate the effectiveness of tooth bleaching. The tabs are uniform in color and expand the shades available on the lighter side, so that patients with teeth that are already A1 or B1 can still see their results. In randomized tests, there was a very high ability for observers to order the tabs on the new bleaching guide from lightest to darkest visually, and match the order of the labels on the tabs. There is nothing more frustrating than working with a patient on bleaching to have them feel disappointed int he results. In my experience some of this disappointment comes simply from the position of the starting and ending tab on the shade guide, and the patient inference about what that means. Using a guide that accurately reflects the process and makes evaluation easy takes this uncertainty out of the process.