Inlays and Onlays Filling

Inlays and Onlays are another procedure of restoring normal tooth structure after decay or teeth damage. This is the recommended procedure when over half of patient’s molar tooth's biting surface is decayed. Inlays and Onlays are better options when the damage is too big for standard filling and yet too small for crowning procedure. An inlay is placed in between the cusps of the tooth, whereas an only will cover one or more of the cusps. They can be made of a gold alloy, porcelain or tooth-colored resin and are cemented into place.

This is also known as indirect fillings because unlike a standard filling that is done in a dentist's office, Inlays and Onlays are made in a laboratory and cemented or bonded to the surface of the tooth during a second visit to the dentist. And unlike standard fillings, inlays and onlays do not weaken the tooth structure, but actually strengthens it. After the procedure, the tooth can bear up to 50 - 75% more chewing force.

An Inlay is done when the replaced tooth structure is within the cusp tip of the tooth. If the damage is more extensive and the new structure covers the entire chewing surface including one or more tooth cusps, then the procedure is called an Onlay.

Inlays and Onlays are performed using very similar procedures. Both require two visits to the dentist. At the first appointment, the dentist begins the procedure by numbing the area using a local anesthetic. The decay and damage is detached using a drill, preparing the tooth for its new surface. After all the damage was removed, an impression is made of the prepared tooth so the Inlay or Onlay material can be cast in a form that will fit the tooth exactly. A temporary restoration is placed on the tooth to protect it until the laboratory makes the new structure and it can be bonded to the tooth. This can take about two to three weeks.

Using the impression, a laboratory prepares the new tooth surface using gold, porcelain or composite resin. Upon return to the dentist's office, the temporary restoration is removed and the surface is cleaned to prepare for the new structure. The dentist will then try in the new restoration to ensure that there is a correct fit that doesn't interfere with the patient’s bite. If the fit is good, using special cement or bonding, the Inlay or Onlay is permanently fastened to the tooth. Some minor adjustment may need to be made to the restoration if there are interferences. To finish the procedure, the dentist will polish the cemented or bonded structure and tooth.

Healing from the preparation of the provisional onlays as well as the attachment of the final restoration is comparable to that of having a cavity filled. The patient may experience some ache or tenderness in the area. This is usually relieved by taking Ibuprofen.

Porcelain Inlays and Onlays are finer alternative than other tooth restoration materials. These were made to perfectly match the shade and shape of patient’s teeth. Porcelain is known to be resilient, strong, and almost undetectable. This protects the tooth or teeth from fracturing and actually strengthens the tooth. In addition, inlays and onlays fit almost perfectly into the prepared surface of the tooth, reducing the size of the seam between the restoration and the tooth. Inlays and onlays require the removal of only decayed areas of the tooth, leaving healthier tooth structure intact and help keep decay from eventually occurring under the restoration.

However, inlays and onlays require a greater initial investment than regular fillings but nonetheless, they are better investment than fillings due to their extremely long life and highly accurate fit. Patients with this type of restoration should not chew ice cubes or any other hard candies. While complications from an inlay are unlikely, it is possible that the tooth preparation may take the dentist very close to the nerve of the tooth. This may result in some sensitivity, and may disturb the nerves so that a root canal is required.