Subjective Evaluation

It is very difficult, particularly for those not trained in distinguishing subtle gradations of yellowish white, to detennine whether a color change has actually occurred, and if so, how great the change was. Thus, it is impossible for dentists or patients to make a valid subjective judgment such as "those teeth are whiter now than three weeks ago".

Many factors may influence the perception of color. A suntan will seem to make the teeth whiter, as will makeup (especially dark lipstick). Darker clothing or hair will have the same effect. The ambient lighting and the overall color impact of a room may also cloud our evaluative processes. Most important, over a treatment period of several weeks, we will forget what the originally noted coloration was.

Therefore, attempting to make strictly subjective evaluations of tooth color modification is of dubious value. Instead, we can choose a control baseline that will be in a suitable location for comparison while not altering color itself.

The most practical baseline solution intraorally is the opposing arch. In home bleaching, generally one arch is treated at a time, while the other arch can be used to monitor treatment progress. This is known as comparative evaluation. Photo courtesy of Dr. Maury Krystell

The patient will readily observe the success of the procedure every time he opens his mouth in front of a mirror. Photo courtesy of Dr. Maury Krystell

Fig, 7-12

A comparative evaluation may also be accomplished with a shade guide tab, but this method leaves much room for interpretation, both from the dentist and the patient. Thus its value in determining treatment success is severely limited. Still, because of its ease of use, it is recommended to always take a baseline shade using shade tabs.

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