1. The starting point

Colour was at the centre of this project from the very beginning. What started as an undergraduate final-degree project soon became a broader reflection on a simple but often overlooked question: how much do we depend on our own eyes when making aesthetic decisions in dentistry? In clinical practice and dental education, we often focus on materials, ceramic systems, digital workflows and laboratory protocols. However, when selecting tooth colour, the clinician's own visual perception remains a decisive part of the process.

2. Why tooth colour matters

Tooth colour selection is a routine procedure in restorative and prosthetic dentistry, but it is also one of the most subjective steps in treatment. From a biological or strictly clinical point of view, colour may not be the most important factor when evaluating a dental restoration. Fit, function, stability and tissue health are essential. However, colour is often one of the first things patients perceive. A restoration may be technically correct, well adapted and functional, but if the shade does not match the surrounding teeth, the patient may still experience it as a failure.

3. Why dental students?

We decided to focus on dental students because dental school is where many visual and clinical routines are first learned. Shade selection is not only a technical act; it is also a habit that develops through training, repetition and feedback. Students are expected to learn how to observe, compare and decide, often using their own visual judgement as the main tool. This made us wonder whether some students might be facing an unnoticed difficulty from the very beginning of their training.

4. A simple task that is not so simple

At first glance, choosing a tooth shade may seem like a simple visual comparison: placing a shade guide next to the tooth and selecting the closest match. In reality, the process is much more complex. Lighting conditions, surrounding colours, translucency, restorative material and visual fatigue can all influence the final decision. Recognising that colour selection depends on both external conditions and individual perception is the first step towards improving how we teach and perform this clinical procedure.

5. When colour perception is not the same for everyone

One of the key ideas behind this study was that colour perception is not identical in all individuals. Some colour vision alterations are evident from childhood, but mild defects may remain unnoticed for years. In everyday life, they may not cause major difficulties. In dentistry, however, small differences in hue, chroma and value can influence aesthetic decisions. This does not mean that a student or clinician with a colour vision alteration cannot practise dentistry. Rather, it means that we should detect these limitations when necessary and provide strategies to compensate for them.

6. How we approached the study

To explore this question, we evaluated colour vision and dental shade selection in a group of dental students. The idea was not only to identify whether colour vision alterations were present, but also to observe whether they could be associated with differences in shade-matching performance. We used standard colour vision tests together with a practical tooth shade selection task, connecting the biological ability to perceive colour with the clinical ability to apply that perception in a dental context.

7. What the results suggested

The results suggested that colour vision alterations may be more relevant in dental education than is usually assumed. Some students showed difficulties in colour discrimination, and these differences were reflected in the shade selection task. For us, the most interesting aspect was not simply identifying students with altered colour vision, but understanding how this could affect a specific dental procedure. The study also raises a broader question for the dental industry. If shade selection still depends heavily on human perception, there is a clear need to develop reliable, accessible and clinically useful systems for colour capture.

8. What these differences may mean in practice

In clinical practice, not every shade selection error has the same relevance. A small mismatch may be acceptable in posterior areas or in restorations with low aesthetic visibility. However, when the restoration is placed in an aesthetically visible area, an inadequate shade selection can have a direct impact on the patient's experience. Even if the restoration is biologically sound, well adapted and functional, the patient may perceive the treatment as unsuccessful if the colour does not integrate naturally with the surrounding teeth.

9. Detecting limitations to compensate for them

One practical message of this study is that detecting a colour vision alteration should not be understood as a limitation of professional capacity. On the contrary, identifying it can help students and clinicians become more aware of their own visual profile and adapt their workflow accordingly. Shade selection can be supported by a second clinical opinion, standardised lighting, calibrated shade guides or digital colour measurement devices. The aim is not to replace the clinician, but to make the decision more reliable and reduce subjectivity.

10. Implications for dental education

These findings have direct implications for dental education. Shade selection is often taught as part of restorative or prosthodontic training, but it may not always receive the same structured attention as other clinical procedures. Students are usually trained to compare, choose and communicate colour, but less often to question the reliability of the visual process itself. Simple screening, better training conditions and objective support tools could make shade selection more consistent and fairer for all students.

11. Looking beyond colour

This project began with a very specific question about colour vision and tooth shade selection, but it led us to a broader reflection on dental training and clinical decision-making. Dentistry is a discipline in which biology, technology, manual skill and perception constantly interact. By recognising variability in colour perception, we can train students better, support clinicians more effectively and encourage tools that make aesthetic decisions more reliable. In the end, improving shade selection is not only about choosing the right colour. It is about understanding how we see, how we decide and how we can provide better care for patients.