When your teeth have a significant amount of decay you have three treatment options: fillings, inlays / onlays, or dental crowns.

Never heard of inlays or onlays before? You’re not alone. Many people outside of the dental profession usually just call them fillings, but inlays and onlays are a distinct treatment option.  Contact Capital Dental Design today if you think you need an inlay or only, or read on to discover more.

Dental onlay - before and after | Capital Dental Design in Richmond

How do inlays and onlays differ from fillings and crowns?

Composite fillings are appropriate when tooth decay has not progressed far. They are made of a resin, which is placed into the freshly drilled and cleaned cavity, then dried with a laser. Fillings are meant to be small. A filling that is too large is in danger of cracking. A cracked filling can lead to everyone’s least-favorite dental treatment ever: the root canal.

Crowns are appropriate when most of the tooth is damaged. At that point, the dentist removes the damaged parts of the tooth, shapes what remains, and places a porcelain crown on top of it to maintain your mouth’s appearance and your ability to chew food. Crowns are always an option, but our approach here at Capital Dental Design is to maintain as much of your original tooth structure as possible.

Inlays and onlays are the weapon of choice when the amount of tooth-damage lies somewhere between those two extremes. Like crowns, they are specifically shaped in a dental lab to fit your tooth and the size of the hole we’re trying to address. Like fillings, they maintain the bulk of the tooth structure.

Inlays and onlays aren’t necessarily made of porcelain, just as fillings aren’t always made of composite. Amalgam fillings remain an option, and inlays/onlays may be made of other metals, like gold. But most of our patients want the option that looks the most natural. Both composite and porcelain help us fix teeth in a way that makes them look “good as new.” Many of our patients prefer those options. 

What is the difference between an inlay and an onlay?

The difference is in where on the tooth your dentist needs to place the inlay or onlay.

An inlay is placed between the cusps of your teeth.

An onlay covers at least one cusp, or even the entire biting surface of your tooth.

(As you may know, a cusp in this case refers simply to a “pointy part” on the biting surface of a tooth.  Your canines have one cusp, whereas your molars and other teeth have several cusps.  They’re what allow you to chew.) 

What are the advantages of porcelain inlays and onlays?

The main advantage of inlays and onlays is that they allow us to preserve as much healthy as possible.  But an inlay or onlay also can offer a better fit for the missing area of the tooth than either a filling or a crown can.

A filling just fills the hole, a crown sits on top, but an inlay or an onlay is meant to slip right into place, like a puzzle piece. That makes them easier to clean and more likely to stay stable and strong, whereas both fillings and crowns can be prone to damage later.

Of course, we do not recommend trying to “time your cavities” so they’re the perfect fit for inlays and onlays! We’d rather fill a tiny cavity than do extensive work on a big one, and you probably don’t want more dental work than you need. This is as good a time as any to remind you that your yearly or twice-yearly dental exam is crucial, because it helps us ensure any cavities don’t get out of hand. 

What are the disadvantages of inlays and onlays?

At $600 to $1000 per tooth, inlays and onlays are more expensive than fillings, but often much less expensive than crowns, which run between $500 to $3000 per tooth. Composite fillings can cost $90 to $250, but by the time we might discuss an inlay or onlay with you, a filling no longer would be enough to keep your mouth healthy. 

What’s involved in an inlay/onlay treatment procedure?

Receiving an inlay or an onlay is a two-step process. On the first visit we will prep the bad tooth and take a mold of the area we intend to replace. We may fill it with a temporary putty to protect it from bacteria and further decay.

We then send the mold to the lab, where it will be fabricated for you. The ceramicists we work with are masters at creating lifelike inlays and onlays. When they’re done creating your inlay or onlay we will ask you to return to get the insert bonded to your teeth.

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