Cosmetic Treatment Choices: Porcelain or Composite?
Patient Choices, an Overview
With patient centred care, here at our practice we will provide you options to treat your concern. The only problem is, how do you as the patient know what to choose?
In this article, I take you through a common choice in deciding between porcelain and composite to cosmetically restore front teeth. The patient here decided to restore a single tooth using composite. It’s only a very simple case and she was really made up with the results. Let’s take a look at what made her decide to go with composite, and let’s see if you would agree…
Firstly, what are porcelain & composite?
Porcelain has until recent years, been the main method of restoring front teeth for decades. A laboratory will fabricate the restoration and then the dentist will cement the porcelain to the tooth. This will commonly be as a veneer-(a thin layer of porcelain made to fit over the surface of the tooth in order to improve the shape, shade and appearance of the tooth).
Composite is a resin material that can be applied directly to teeth. Sometimes it can be used like a veneer, often it is just added to the edges of the teeth. With recent years, these composite materials have improved to make them a much more favourable option with patients.
How long do they each take to make?
Porcelain veneers will often require two or more visits to complete, occasionally we will discuss providing a mock-up of how the new restorations will look and sometimes this can require more visits.
Composite can be applied at the chair-side and therefore is often completed in one visit.
Will they damage my teeth?
Porcelain veneers will often, but not always, require some tooth reduction and therefore it is less biologically kind to your teeth.
Composite requires no tooth reduction. Provided you ensure that you clean well and are careful with how often you consume sugar then there are very few risks associated.
How long do they last for?
Porcelain is generally more durable. Despite being very brittle, when we bond this material to tooth, it becomes quite strong. However, if porcelain chips then it is very difficult to repair. Typically porcelain veneers will last for 10 years.
Composite will tend to last for 4-10 years. It can stain and chip but unlike porcelain, it can be repaired and polished. When multiple restorations are planned then if a single one chips, a case completed in composite poses far fewer challenges to addressing and fixing the problem, I can simply add some more!
Which looks better?
Porcelain generally looks better and will retain it’s looks for longer. Having said that, modern composite is challenging this, and it depends largely on the skills of both the dentist and laboratory technician.
What do they cost?
Porcelain will often be more expensive because of the need for more time and to pay for the laboratory cost. In this case, the work took 40 minutes to complete and therefore the costs were relatively low.
There is a consideration over a lifetime however that there is the need to occasionally repair composite and you would generally expect to replace it more often.
To conclude…
As the author, I tend to find that more of my patients are choosing composite for cosmetic treatment. I believe that this is a trend which is likely to increase further. As part of patient centred care, patients will still ask and rely on their dentists’ own views. When I am asked this then I will tend to favour composite because it is more biologically kind and because this is what works well in my hands.
Having said that, a well made porcelain veneer can far outlast a composite veneer and because of it’s better aesthetics then it can still provide the best results.
The truth is, you don’t need to worry about making the wrong decision, often it is like having a choice between red or white wine, we each will have a favourite, neither is wrong provided you have considered their merits!
