**1. Introduction**

Esthetic dentistry has been a concern for patients visiting dental clinics. Patients have more expectations and are looking for higher esthetic results as a consequence of increased awareness and the impact of social media [1]. Usually, patients will assess the dentist's work by function, comfort, speech, and esthetics. The form and alignment of the teeth determine the beauty of the smile; the balance between the color of the teeth and the soft tissues is considered fundamental in determining the satisfaction of the person's dental appearance [2,3]. Systems evolved in defining the shade of teeth depend on three attributes: Hue, Chroma, and Value. The Hue is described as the character of appearance, which is discernible as (red, green, blue, etc.) and depends on the wavelength of each color. Chroma is the saturation of the color as it distinguishes a strong color from a weak one. The value is the color brightness, which compiles the lightness or darkness of the color [4].

**Citation:** Alsayed, H.; Alaqeely, R.; Almazrouei, N.; Alzahrani, M.; Alzahrani, F.; Bin Oun, A.; Alshihri, A. Tooth Shade Relationship with Age, Gender, and Skin Color in a Saudi Population: A Cross-Sectional Study. *Appl. Sci.* **2022**, *12*, 6315. https://doi.org/10.3390/ app12136315

Academic Editor: Mary Anne Melo

Received: 11 May 2022 Accepted: 18 June 2022 Published: 21 June 2022

**Publisher's Note:** MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affiliations.

**Copyright:** © 2022 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).

One of the obstacles that most dentists are facing is matching a restoration to a natural tooth shade. However, patients described pearly white teeth as preferable [2,5]. Identifying the tooth shade will aid dentists in using fewer amounts of shade tabs and guides required to suit the patients' desires. This will also aid in providing better esthetic results according to the patients' age, gender, and skin color. According to Jahaniri et al., young patients were more likely to have teeth with a high value (lighter teeth) [6,7]. Factors like gender, age, and skin color may contribute to the method of shade selection [8,9]. In Sudan, for instance, shades A3, A2, and A1 were the most common tooth shades, respectively [10]. Karaman et al., in Turkey, reported that shade A2 was most observed in central and lateral incisors for all age groups. For the canines, B3 was most observed for the youngest two groups and A3.5 for the oldest two groups [11]. A study conducted in Jordan comparing tooth shade to skin color revealed that Jordanians have a light tooth value and that people with a dark skin complex have lighter teeth [12]. The skin color of an individual might help the prosthodontist in picking the artificial teeth shade in case of a complete denture [8]. Jahangiri et al. concluded that 50% of persons with low-value teeth had fair skin, whereas 17% had dark skin [6]. However, a study in Nepal [13], and another in India [14], exhibited no difference between all skin colors and tooth shades. Another study conducted in Korea reported that lighter and less chromatic central incisors were characteristics of female subjects in all age groups [15]. Gómez-Polo et al. revealed that age was stronger than gender in all color coordinates. However, females have lighter teeth than males in the plots [9]. Karaman et al. also showed that gender is statistically not related to a color value or Chroma [11]. In Saudi Arabia, a study in the southern region found that the shade gets darker and more yellow with age [16]. However, one ethnic group was examined in this study and could not be generalized to a Saudi Arabia population. Nowadays, high expectations from social media and patient awareness demand a quality level of training and knowledge regarding all aspects of esthetic dentistry. The process of shade selection is challenging because it is a subjective process. Therefore, patient-centered treatments and guidance in shade selection lead to a successful outcome when executed with prior knowledge of how the color is perceived.

Therefore, this research aims to assess teeth shades and their relationship with age, gender, and skin color in a Saudi population.
