By Dr George Druttman

There are many reasons why veneering a tooth or even full arches of teeth may be considered and appropriate. These vary from matching the colour of a tooth to its neighbours through to creating a full dental smile makeover.

Aside of deciding how many teeth may need to be veneered, the question of which material to use often arises.

Quartz composite and porcelain materials

In essence there are two materials available in common use and these are quartz composite and porcelain. Both have their advantages, disadvantages, indications and contraindications quite aside of significant cost differences.

Of the two, porcelain is much harder, more stable and durable, longer lasting. However, it may sometimes require more tooth ‘preparation’ and certainly involves significantly greater cost (three to four times as much as composite).
So, although, in terms of material properties, porcelain is generally superior to quartz composite, there are times when the use of the latter is more appropriate.

When composite bonding material is more appropriate?

• When small amounts of material are needed to create changes, as in the example of not necessarily needing a full veneer. When there is a requirement for absolutely no or very minimal removal of tooth substance to create the change (usually in shape rather than colour ) of tooth.
• In children and young adults, when there is ‘time’ in the future to replace composite with porcelain.
• Costs are very often a very significant influencing factor, particularly when mor than one tooth is involved. In the main one can achieve almost exactly the same aesthetic results with both materials .

The cost differences may, in fact , dictate whether a particular individual can afford to achieve the result they want or its beyond their reach. Having composite veneers placed does mean that the individual must appreciate and accept that they may need replacing after a number of years , certainly much sooner than with porcelain.

• If a result needs to be achieved quickly, composite veneers , even in large ‘multiples’ can be completed in one appointment. Porcelain invariably needs more than one as the restoration(s) usually need to be made by a dental technician in a laboratory.

Treatment Costs

Obviously different practices charge different fee levels for dental veneers. However, here a few examples of treatments costs:

• Correcting a single dark tooth (often a front one that has been root canal treated previously). Porcelain really is ideal in such situations , however restoring such a tooth to look exactly as its healthy neighbour could cost over £1,000 in porcelain, whereas in composite the fee may be around £ 300.
• If six upper front teeth are to be treated , porcelain restorations could cost about £ 6,000, whereas composite may be approx. £ 1,500.
• A full upper dental arch makeover, for example involving twelve upper and possibly six lower front teeth, a total of eighteen teeth, could cost £15,000 to £ 20,000 if all done in porcelain. If composite is used, the cost may reduce to £ 3,500 – £ 4,500.

Longevity of composite and porcelain veneers

Composite veneers last very different lengths of time in different people, depending on many factors. These can include the strength of the bite, presence of a tooth grinding habit, smoking, black coffee and red wine consumption and the technique used by the dentist.

Generally, one should expect a porcelain veneer to last 3-5 years, although they can last 10 -15 years . Invariably composite (unlike porcelain) may need to be refreshed and re-polished regularly, as the surface does tend to ‘degrade’ over a few years . Moreover, if a porcelain veneer fractures , it needs full replacement , whereas if this happens to composite, it can often be repaired relatively inexpensively and quickly.

Is the composite bonding procedure painful?

Bonding composite to teeth is non-invasive procedure and generally involves almost no drilling. Consequently, the treatment is carried out without even the need for local anaesthetic.

For those patients that are generally dentally anxious, if a practice provides inhalation sedation (known as Gas & Air / Nitrous Oxide & Oxygen), then using this as a relaxation modality is absolutely sufficient for a composite bonding procedure, no matter how extensive.