Editing teeth in photoshop (detailled)

Hi!
I am a dentist and I have some problems with editing teeth on photos.
Usually photos are taken with a dslr + macro lens + ringflash so the quality is good.
The aim is to edit the photo and show the patient a simulated possible outcome of the treatment suggested.
to do so there are two ways:
1. smile libraries: there are photos of teeth available which can be copied and pasted into the picture. apart from these being more expensive than the camera and photoshop are the result always looking beautiful but very often unrealistic and due to the anatomical situation of the patent not achievable.
2. editing the existing photo. this is the better way. here i have some questions:
     a. when whitening the teeth i used to make a selection of the teeth and whiten using hue saturation and lightness. this works very well as long as the teeth have all the same colour. if the teeth have different colours the overall brightness increases but the differences between the teeth are still visible. is there a better way of doing it? or do i have to choose a different blend mode (i don't completely understand blendmodes)?
     b. reshaping of the teeth. do far i used to copy and paste existing parts and edited the copied parts with liquify and/or distort. this works quite well but takes a long time. i visited a course about cosmetic dentistry and the speaker just painted the toothshape he was aiming for on the photo. how did he do this? i tried with clone but the results are not good and too often my sample point goes beyond the gumline and i have red teeth . i also tried to sample colour but then the result looks unreal. do i have to generate a pattern?
     c. the person even painted reflections on the teeth. how is this done? do i need a special brush?
thanks for the help!

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