Objective To compare the aesthetic effects and periodontal health status of porcelain veneers and light-cured composite resin veneers in the restoration of dental fluorosis. Methods A total of 96 patients with dental fluorosis (196 affected teeth) treated in our hospital from May 2023 to May 2025 were selected, and they were divided into the control group (48 patients, 96 affected teeth) and the observation group (48 patients, 100 affected teeth) by the random number table method. The control group received nano light-cured composite resin veneer restoration, and the observation group received cast porcelain veneer restoration. The restoration success rate, aesthetic effect, inflammatory factor levels in gingival crevicular fluid and periodontal health status were compared between the two groups. Results The restoration success rate of the observation group was 96.00%, which was higher than 88.54% of the control group (P <0.05). At 12 months after restoration, the pink esthetic score (PES) and white esthetic score (WES) in the observation group were higher than those in the control group (P <0.05). At 12 months after restoration, the levels of tumor necrosis factor-α (TNF-α) and matrix metalloproteinase-2 (MMP-2) in gingival crevicular fluid of the observation group were lower than those of the control group (P <0.05). At 12 months after restoration, the sulcus bleeding index (SBI), plaque index (PLI) and gingival index (GI) of the observation group were lower than those of the control group (P <0.05). Conclusion Porcelain veneers achieve better aesthetic effects than light-cured composite resin veneers in the restoration of dental fluorosis, with a high restoration success rate. It is more conducive to maintaining periodontal health, which is worthy of clinical priority application.