When restoring a tooth that has been damaged by decay or trauma, dental inlays and onlays offer a strong, durable, and aesthetically pleasing solution. Both types of restorations provide an alternative to traditional fillings and are designed to repair larger cavities or damage in a way that blends seamlessly with your natural teeth.

What Are Inlays and Onlays?

Inlays and onlays are both custom-made dental restorations that are used to repair teeth that have been damaged by decay or trauma. They are typically made of porcelain, composite resin, or gold and are designed to fit perfectly into a prepared cavity in your tooth. While both serve the same function of restoring a tooth, they differ in terms of the amount of tooth structure they cover.

• Inlays: Inlays are designed to fit within the grooves or cusps of the tooth. They are used to repair cavities that are located in the center of the tooth, typically on the chewing surface of the back teeth (molars). Inlays are ideal for situations where the damage is too large for a filling but does not extend to the edges of the tooth.
• Onlays: Onlays are similar to inlays, but they cover a larger portion of the tooth, including one or more of the cusps (the pointed edges of the tooth). Onlays are used when the damage extends beyond the center of the tooth but does not require a full crown. Onlays provide additional strength and protection to the tooth compared to inlays.

Both inlays and onlays are crafted outside of the mouth, usually in a dental lab, and then bonded to the tooth with a strong adhesive. The procedure involves two visits to the dentist—one for preparing the tooth and taking impressions and a second visit for placing the restoration.

Benefits of Inlays and Onlays

• Aesthetic Appeal: One of the primary reasons patients choose inlays and onlays is their natural appearance. Both types of restorations are custom-made to match the colour and shape of your natural teeth, providing a seamless blend with your smile. Porcelain inlays and onlays are particularly effective in achieving a natural look because they reflect light similarly to natural tooth enamel.
• Durability and Strength: Inlays and onlays are highly durable and can withstand the forces of chewing and grinding. Porcelain and gold restorations, in particular, are known for their strength and longevity. These restorations can last for many years—often 10-15 years or longer—making them a reliable choice for repairing damaged teeth.
• Conservation of Tooth Structure: Inlays and onlays are considered more conservative than crowns because they require less removal of healthy tooth tissue. The dentist will only remove the damaged or decayed portion of the tooth, preserving as much of the natural tooth as possible. This is an important benefit for patients who want to maintain their tooth’s structural integrity.
• Fit and Comfort: Inlays and onlays are custom-designed to fit your tooth precisely, which helps to ensure a comfortable bite and natural function. Unlike traditional fillings, which may shrink or wear down over time, inlays and onlays are stable and durable, providing long-lasting comfort and performance.
• Improved Tooth Function: Inlays and onlays restore the function of your tooth, allowing you to chew and speak normally. Because they fit snugly within the tooth structure, they help to maintain the tooth’s strength and integrity. This reduces the risk of further damage or fractures that may occur with large cavities.
• Resistance to Staining: Porcelain inlays and onlays are resistant to staining, which makes them an excellent choice for visible teeth. Unlike composite fillings, which can discolour over time, porcelain maintains its colour and appearance, keeping your smile looking bright and natural.

The Difference Between Inlays and Onlays

Although inlays and onlays are similar in many ways, the main difference lies in the amount of the tooth they cover:

• Inlays: These restorations are designed to fit within the tooth's grooves, covering only the area where the decay has occurred. Inlays are ideal for cavities that affect the center of the tooth but do not extend to the cusps or edges.
• Onlays: Onlays, on the other hand, extend beyond the grooves to cover the cusps or edges of the tooth. Onlays are a more comprehensive solution for teeth that have sustained significant damage or decay, providing additional support and strength to the tooth.

In general, onlays are used when the tooth’s damage is more extensive, while inlays are used for smaller, less severe cavities. Both options are highly effective at restoring the tooth’s function and appearance.

When Are Inlays and Onlays Recommended?

Inlays and onlays are recommended for patients who have:

• Moderate Decay or Damage If a tooth has significant decay or damage but does not require a full crown, an inlay or onlay can be a suitable solution. These restorations provide additional strength and protection to the tooth while preserving more of the natural tooth structure.
• Teeth with Large Fillings In some cases, a tooth may have a large filling that is beginning to wear out or break down. If the filling is no longer sufficient to support the tooth, an inlay or onlay can provide a more durable and long-lasting solution.
• Cosmetic Concerns For patients seeking a more aesthetic restoration, inlays and onlays are great options. Because they are custom-made to match the natural colour of the tooth, they provide a highly aesthetic solution for cavities in visible areas, such as the front or back teeth.
• Strengthening Weak Teeth Inlays and onlays are often used to restore teeth that are structurally weak due to large cavities or cracks. These restorations help to reinforce the tooth and prevent it from fracturing or breaking.

The Procedure for Inlays and Onlays

The process for getting an inlay or onlay typically involves two visits to the dentist:

First Visit:

• Examination and Preparation: The dentist will examine the tooth and take X-rays to determine the extent of the damage or decay. If an inlay or onlay is recommended, the damaged portion of the tooth will be removed, and the cavity will be cleaned and prepared for restoration.
• Impressions: The dentist will take impressions of the tooth and surrounding area to create a custom inlay or onlay. In some cases, digital impressions may be used instead of traditional moulds.
• Temporary Restoration: If necessary, the dentist will place a temporary restoration to protect the tooth while the permanent inlay or onlay is being fabricated.

Second Visit:

• Placement: Once the custom inlay or onlay is ready, the dentist will remove the temporary restoration and place the new restoration onto the tooth. The dentist will check the fit and make any necessary adjustments to ensure the restoration aligns properly with your bite.
• Bonding: Once the restoration is properly adjusted, it will be bonded to the tooth using a strong adhesive. The dentist will then polish the restoration to give it a smooth, natural appearance.
• Final Adjustments: The dentist will make any final adjustments to ensure that the restoration fits comfortably and that your bite is normal.

Are Inlays and Onlays Covered by Insurance?

Dental insurance coverage for inlays and onlays may vary depending on your plan. In many cases, these restorations are considered cosmetic treatments, and insurance may only cover part of the cost. It’s important to check with your insurance provider to understand your coverage and any potential out-of-pocket costs.

Conclusion

Inlays and onlays are excellent options for restoring damaged or decayed teeth with both strength and aesthetics in mind. They provide a durable, natural-looking alternative to traditional fillings, and they can help preserve the structural integrity of your teeth. Whether you have a small cavity or significant damage to a tooth, inlays and onlays, offer a versatile and long-lasting solution for restoring both function and appearance. If you think inlays or onlays might be right for you, consult with your dentist to discuss your options and determine the best course of treatment for your needs.

Preserve your tooth structure with inlays and onlays at Caring Dental. Dr. Joseph Prasad offers these custom restorations for long-lasting strength and aesthetics.