Porcelain, Ceramic or Composite: Which Material?

A fine gem is judged by its color, clarity, cut and durability, and dental materials are chosen by much the same qualities. When a tooth needs to be repaired, reshaped or replaced, the material matters as much as the procedure: it decides how natural the tooth looks, how well it resists stains and chips, and how much of your own tooth has to be removed to place it. Most tooth-colored work falls into three families: porcelain, ceramic and composite resin.

This guide explains how each material behaves, which treatments use it, how implants fit in, and how the Timonium office of Dr. Steven W. Haywood, DDS decides which one suits a tooth.

Why the material matters

Two teeth can be restored with the same kind of treatment and look and wear very differently because of what they are made of. When you compare options, four qualities are worth asking about:

• Appearance. Natural enamel is slightly translucent, not a flat white. A good material lets light pass through the way enamel does.
• Stain resistance. Some materials hold their color for years; others pick up stain from coffee, tea and red wine.
• Strength. Front teeth and back teeth face very different forces, and people who grind need tougher choices.
• How much tooth is preserved. The less a tooth is reduced, the better, so conservative options come first when they will do the job.

Porcelain: veneers, crowns and bridges

Porcelain is the material most people picture when they think of a cosmetic smile, and for good reason. Ultra-thin porcelain stays naturally translucent and shiny, like natural enamel, even once it is bonded to the tooth. Porcelain resists stains better than natural teeth or composite, and it doesn’t break as easily or wear the way resin can.

Where porcelain is used

• Porcelain veneers, thin shells bonded to the front of teeth to correct gaps, chips, stains and crooked teeth. A veneer can be as thin as a contact lens.
• Prepless veneers, which preserve most if not all of the natural enamel for patients who qualify.
• Porcelain crowns, which cover and protect a tooth that has been extensively damaged, and are made to replicate the color and translucence of your natural teeth.
• Bridges, where the practice specializes in all-ceramic and tooth-colored options; in most cases bridgework contains high-grade porcelain, or porcelain fused to zirconia or gold.

How porcelain is made

At the practice, veneers are hand-crafted in the USA by master ceramists, using US-certified laboratories chosen for their ability to customize each case. Each veneer blends colors and translucencies with the small details that make a tooth look like a tooth, and you evaluate a trial set before the final set is made.

Composite resin: bonding and tooth-colored fillings

Composite resin is a tooth-colored material that is shaped directly on the tooth. For fillings, it is mixed at the time of treatment to match the color of your natural teeth and bonded in place, so it blends in instead of drawing attention.

Where composite is used

• Dental bonding, which repairs chips, fractures and discoloration, closes gaps and changes the shape of teeth. When it covers the front of a tooth, it is also called a direct veneer.
• Tooth-colored fillings, completed in a single visit.

Strengths and trade-offs

Composite is often the most conservative cosmetic option: it is sculpted on the spot, usually in a single visit, typically with no anesthesia, and it is one of the most affordable cosmetic procedures. The trade-offs are durability and color. Resin can stain, so brush or at least rinse well after cola, coffee, tea or red wine. It is not as strong as enamel and can chip, and bonded veneers have a shorter lifespan than porcelain. Bonding is also often a first step in a larger makeover.

Ceramic and processed composite: inlays and onlays

Between a filling and a crown sits a restoration many people have never heard of. Inlays and onlays are bonded ceramic, resin or processed composite restorations for a tooth with partial damage. An inlay is bonded inside the remaining tooth; an onlay also restores part of the biting cusp.

Made from materials that match your teeth, they are designed to be undetectable, even on front teeth, and they are among the longest-lasting and strongest dental restorations. Onlays are sometimes called “inside crowns” because they are strong while conserving the healthy parts of a damaged tooth. Gold is available, but most patients prefer the natural look of tooth-colored materials. Learn more about inlays and onlays.

Titanium or ceramic: materials for dental implants

When a tooth is missing, the material question moves below the gum line. An implant has three parts: the implant that replaces the root, the abutment that supports the new tooth, and the crown.

• Titanium implants are the most common and successful type. Titanium is biocompatible and fuses well with bone.
• Ceramic and zirconia implants are also available and are essentially the holistic implant of choice for patients who want to avoid metal.
• Front teeth often use smaller implants and custom ceramic posts so the gum and tooth look natural.

For more on the parts and sizes, read what are dental implants?

The material the practice doesn’t use

Dr. Haywood never uses amalgam fillings. Metal can discolor and age teeth, and has been linked to illness because of its mercury content. Old metal fillings can be removed under rigorous safety protocols that follow the best practices of holistic dental associations, and replaced with tooth-colored materials. See mercury-free dentistry.

For patients concerned about how materials affect the whole body, holistic dentistry at the practice means non-toxic, metal-free and biocompatible restorations, with no mercury, nickel or bisphenol plastics.

How Dr. Haywood, dentist and AACD member, chooses a material

No single material is best for every tooth. The choice comes from your teeth and your goals:

• How damaged the tooth is. A small chip may need only bonding; a tooth with little structure left may need a crown. When a conservative repair will work, it comes first.
• Where the tooth is. Front teeth are judged mostly on appearance; back teeth need to handle chewing forces.
• Your bite and habits. Grinding changes which materials will last, and bite protection is recommended for any cosmetic treatment.
• The color underneath. Over a very dark tooth, a veneer may need to be more opaque or thicker in that area.
• Your priorities. A metal-free mouth, a one-visit repair or the longest-lasting option can each point to a different choice.

Dr. Haywood is a member of the American Academy of Cosmetic Dentistry, trained at New York University’s Aesthetic Continuum, and insists on a natural, never-fake look. Before-and-after imaging is part of every cosmetic evaluation, so you can preview the result. If you are deciding how much of a front tooth to cover, see crown or veneer for a front tooth?

Caring for each material

• Porcelain: keep up with home care and professional visits, and never use your teeth to open objects or cut things.
• Composite: rinse after staining drinks, avoid biting hard objects, and expect touch-ups over time.
• Inlays, onlays and crowns: floss carefully at the edges, where decay can start.
• Implants: brush and floss them much like natural teeth, with extra attention, and wear a night guard if you grind.

For a full routine, read preventative maintenance for your smile.

Frequently asked questions

Is porcelain or composite better for veneers?

Porcelain resists stains better, doesn’t break as easily and looks more natural over time. Composite is more conservative, can be done in one visit and is easier to adjust. Your teeth and goals decide which suits you.

Are tooth-colored fillings as good as metal?

The practice uses only tooth-colored materials. Composite is bonded to the tooth, and bonded inlays and onlays are among the strongest restorations available.

What is the holistic choice for implants?

Ceramic and zirconia implants are essentially the holistic implant of choice for patients who would rather avoid metal.

Can old silver fillings be replaced for looks alone?

Yes, and there are health reasons too: metal fillings can wear or pull away and let decay form underneath. Replacement follows safe removal protocols.

Talk through your options in Timonium

If you are weighing porcelain, ceramic or composite for a tooth, a consultation shows which fits. Request an appointment or call (410) 453-9399. The office of Dr. Steven W. Haywood, DDS is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, serving Timonium, Towson, Pikesville and Baltimore. Explore cosmetic dentistry in Timonium, or read four smile boosters for home and the dental chair.