Working with Richmond dental practices.
Richmond practices frequently work across languages and across quite different expectations of what a restoration should look like. Both affect how a case is best communicated to the laboratory.
Shade expectations are not universal
There is no single standard for what a restoration should look like. Some patients want a restoration that disappears beside its neighbours; others specifically want it brighter, and would be dissatisfied by a technically perfect match to a naturally chromatic tooth.
Neither preference is wrong, and a laboratory has no way of knowing which applies unless it is told. A restoration built to match precisely, delivered to a patient who wanted it lighter, is a remake that nobody could have prevented at the bench.
Establish the patient's preference before treatment and record it on the prescription. Anterior shade matching covers how to have that conversation before the restoration is made rather than after.
Communicating across languages
Where a patient and clinician are working across a language barrier, or where a family member is interpreting, aesthetic expectations are among the easiest things to lose in translation. Terms like natural, brighter and matching carry different assumptions.
Photographs help enormously here, and so does a provisional. A patient who can see a proposed form and shade in their own mouth is giving informed feedback rather than approving a description.
That is worth the extra appointment on any case where appearance matters and the discussion has been conducted through an interpreter.
Documenting what the patient agreed to
Where expectations are involved, a photographic record of the provisional or the try-in, taken at the point the patient expressed satisfaction, is useful for both sides.
It is not a defensive measure so much as a reference. If a patient later raises a concern, everyone can see what was agreed and at what stage — and frequently the concern turns out to relate to something else entirely.
Clinical photographs are health information and need the same handling as the rest of the record. Restorative photography covers consent, storage and what to capture at each stage.
Patients who research before they attend
A well-informed patient will frequently arrive having read about materials and having formed a view — often a preference for metal-free restorations, sometimes a specific brand name encountered online.
Metal-free is a reasonable preference to accommodate and not a clinical superiority claim. Metal-ceramic and cast gold have the longest track records available and remain the right answer for certain long spans, non-ideal preparations and cases involving attachments or existing partial dentures.
Where a patient's preference and the clinical indication diverge, that is a conversation to have before preparation. If the patient's preference is going to govern, the laboratory needs to know that is a decision rather than an oversight.
Records that travel with the patient
Practices in a mobile population regularly treat patients whose earlier restorative work was done elsewhere, sometimes in another country, with no records available.
The material of an existing restoration cannot be identified reliably from a die or a scan, which makes matching into an unknown ceramic considerably harder than matching a natural tooth. A photograph helps; the original prescription helps more.
Where the existing restoration is discoloured or a poor match itself, the better conversation is usually about replacing rather than matching into it.
Younger patients and elective work
Elective aesthetic treatment tends to involve younger patients with highly characterized natural teeth — pronounced incisal translucency, mamelon structure, white flecking and strong surface texture.
Those features are what make a restoration read as natural, and they are exactly what a shade designation cannot carry. A written note saying some incisal translucency conveys almost nothing; a photograph of the adjacent tooth shows the ceramist how far the translucency extends and how abruptly it transitions.
Younger dentitions also show more surface texture than a textbook form suggests. Matching an eighteen-year-old's central to a smooth, glossy restoration produces a mismatch the patient will notice without being able to name it.
Submitting cases
Digital scans and conventional impressions are both accepted, and cases move by UPS and Purolator. Fairmont works with practices throughout British Columbia and across Canada from the laboratory in Burnaby.
For a demanding anterior case, patients can attend for colour matching by appointment through the practice.
A practice in Richmond
Fairmont combines experienced technicians, modern technology and exceptional customer service into one laboratory partnership. Their commitment to precision and consistency has made them a valuable resource for our practice.