You've heard of dental fillings and crowns, but have you heard of inlays and onlays? In the past, dental crowns were always the go-to solution for restoring teeth too damaged to be repaired with fillings. But today, there are intermediary options: Inlays and Onlays.
Inlays and onlays (also known as indirect fillings) are strong, durable tooth restorations that are custom made to repair a tooth, and are great options for restoring teeth with medium to large cavities. Large fillings will actually weaken a tooth’s structure, which greatly increases the risk of the tooth breaking, cracking, and eventually requiring further and more complicated treatment like root canal therapy. And though dental crowns are strong and durable, they always require a significant amount of tooth structure removal in order to fit the crown over the existing tooth, even if a lot of healthy tooth structure exists.
In comparison, indirect fillings actually strengthen teeth, and typically do not require the removal of much healthy dental structure.
Simply put, inlays fit “in” the tooth while onlays fit “on” top of the tooth.
Inlays fill the space in between a tooth’s cusps (the raised portions on the biting surfaces of teeth) and are used to repair teeth that have decay or damage between the cusps. If damage is too widespread or deep for a simple filling but does not affect the cusps, an inlay may be recommended.
Onlays spread over a tooth’s cusps and lay on the top of the tooth, molded to restore the shape and structure of the tooth. If patients have a chipped, broken, or decayed area of a tooth that includes one or more cusps, an onlay may be recommended.
Inlays and onlays are typically completed in two easy office visits.
During the first visit, your dentist will prepare your damaged tooth, take an impression, and place a temporary filling to protect the treated tooth. Between your two dental visits, the dental impression is sent to a dental lab to create the indirect filling, which is usually crafted from shade-matched porcelain. During the second visit, the temporary filling is removed and the custom-made indirect filling is cemented into place, resulting in a strong, beautifully natural looking restored tooth.
While inlays and onlays tend to cost slightly more than traditional fillings, they are a great investment due to their longevity, strength, stain resistance, and natural appearance. Patients who practice good oral hygiene (flossing and brushing daily) usually see their indirect filling last 10-20 years or longer.
If you have a damaged or decayed tooth and seek to be conservative in your dental care – meaning that you prefer solutions that preserve the maximum amount of natural tooth structure while maintaining the form and function of your bite - inlays and onlays could be the perfect choice for you.