When you are missing more than half of the tooth or the decay is too large and would undermine the tooth integrity, a filling is no longer the best treatment choice. In these cases, the best treatment option your doctors, at Esthetic Family Dentistry, will choose for restoring the tooth may be an inlay, onlay or a crown. A cosmetic dentist procedure, this can help restore your teeth to a natural look.
Both inlays and onlays are considered “indirect” fillings, meaning that they are fabricated outside the mouth (generally at a dental lab). They can be made of porcelain, gold, or composite resin. The dentist will bond these pieces to the damaged area of the tooth. This is in contrast to a “direct” filling, which is applied directly to the cavity by the dentist in one office visit. An indirect filling is considered an “inlay” when it fits within the little points or “cusps” of a back (premolar or molar) tooth. An onlay is a more substantial reconstruction, similar to the inlay, but extended over one or more of the cusps of the tooth. In some cases, where the damage of the tooth is not extensive enough to merit an entire crown, onlays can provide an extremely good alternative.
Getting an inlay or onlay is very much like what you would experience having a crown placed, with one important distinction: less of your natural tooth structure will need to be removed by drilling when you receive an inlay or onlay. When you get a crown, the tooth needs to undergo significant reshaping so that it will fit inside its new covering. Since dentistry’s goal is to preserve as much of your natural tooth structure as possible, inlays and onlays may be recommended instead of crowns when a tooth can be restored with this more conservative type of treatment.
The first steps in getting an inlay or onlay are numbing the tooth and surrounding area with a local anesthetic, and then removing the decay. This is done in order to prevent the decay, which is actually a type of infection, from progressing deeper into the tooth.
Once the tooth has been prepared, an impression of it is made (either digitally or with a putty-like material) and sent to the dental laboratory. There, the impression is used to make a model of your tooth for the creation of your inlay/onlay. The final restoration can be made out of gold or a tooth-colored ceramic or resin.
Before you leave the office, a temporary filling will be attached to your tooth to protect it until the permanent restoration is ready. At your second visit, the permanent inlay/onlay will be attached to your tooth with either a resin that hardens when exposed to a special light source, or a type of permanent cement.
Inlays and onlays are strong, long-lasting, and require no greater level of care than any other tooth. Conscientious daily brushing and flossing, and regular professional cleanings at the dental office are all you need to make sure your restoration lasts for years to come.