Investigating working practices of dentists on shade taking: Evidence based good practice versus observed practice

The aim of this study was to investigate UK dentists' working practices on shade taking and to assess whether these clinical practices are in accordance with evidence-based guidelines.

A cross-sectional survey was carried out using a questionnaire designed to elicit quantitative and qualitative data. This included two clinical scenarios (vignettes), which required respondents to describe the steps they would take during shade taking and the prescription sent to the dental technician.

170 completed questionnaires were analyzed. 167 respondents (98.9 %) used manual methods for shade taking. 98 (57.6 %; 95% CI: 50 %, 65 %) respondents followed guidelines on the first vignette, 73 (42.9 %; 95% CI:35 %,51 %) followed guidelines on the second and 41(26.5 %; 95% CI:20 %,33 %) followed guidelines for both. Specialist Professional status (χ2₄= 10.76;p = 0.03) and more frequent use of daylight (χ2 _lin = 6.09;p = 0.01) were both predictive of good practice. Qualitative data analyses revealed several themes: a) the time shade was taken, b) light source used, c) shades for different aspects of the tooth, d) dental care professional (DCP) opinion, and e) photographic support.

This study demonstrated that dentists needed to improve their shade taking techniques. A quarter of respondents consistently followed evidence-based good practice guidelines; the remaining three quarters undertook shade taking with a degree of chance and possibly guesswork, potentially generating errors in communication with dental laboratories, resulting in sub-optimal clinical outcomes. Appropriate training needs to be incorporated in the relevant dental curricula. This study highlighted the importance of compiling accurate and detailed laboratory prescriptions in relation to the shade of the restorations to be fabricated.