The clinical measurement of tooth colour and stain

There are many contributory factors to tooth colour and different techniques for its measurement. The aim of this paper is to evaluate methods of tooth colour and stain measurement, with an emphasis on recent advances in objective clinical measurement techniques. The overall colour effect of natural teeth is created by a combination of light which is reflected and scattered by tooth enamel and the underlying dentine. Developmental defects of the dentition can affect the intrinsic discolouration of teeth, for example, amelogenesis imperfecta and dentinogenesis imperfecta. Extrinsic discolouration is predominantly caused by stain build up on a tooth surface from bacteria, foodstuffs or metalic compounds. Tooth colour and stain measurement are currently assessed using a wide range of measurement methods divided into subjective (visual shade matching) and objective instrumental assessment such as by colourimetry, spectrophotometry and digital image analysis. The most popular method of assessing tooth colour clinically is visual shade matching, as this approach is quick and simple to use. However, variation in results can occur as a consequence of the subjective nature of this method. The instrumental approaches including quantitative light-induced fluorescence remove or significantly reduce the subjective component. Image analysis appears to be the most suitable method for tooth colour measurement and further work is being carried out to establish this approach.