Inlays and Onlays

by Wisteria Family Dentistry. 2024/09/18.

Dental inlays and onlays are types of indirect restorations used to repair teeth with moderate decay or damage that do not require a full crown. Inlays fit within the cusps of the tooth, while onlays extend over one or more of the cusps. These restorations offer a more conservative approach compared to full crowns, as they preserve more of the natural tooth structure. Unlike direct fillings that are applied and shaped inside the tooth during a single visit, inlays and onlays are fabricated outside of the mouth, usually in a dental laboratory, and then bonded to the tooth.

Historically, the use of inlays and onlays dates back to the early 20th century, with advancements in dental practices and materials enhancing their efficacy. Initially made from gold for its durability and biocompatibility, modern inlays and onlays are now commonly made from porcelain, composite resin, and ceramics, which offer the advantage of being aesthetically pleasing and closely matching the natural tooth color. These materials not only provide strength and durability but also contribute to the longevity and effectiveness of the restorations, making them a popular choice among both dentists and patients.

Inlays and onlays are often recommended for addressing a variety of common dental issues such as cavities, fractures, and extensive decay that cannot be effectively treated with simple fillings. These restorations are ideal for situations where a tooth has suffered moderate damage but still retains enough healthy structure to avoid the need for a crown. Inlays and onlays can also be used to replace older or failing fillings, enhancing the strength and stability of the tooth.

One of the significant benefits of inlays and onlays over traditional fillings and crowns is their ability to preserve more of the natural tooth structure. While fillings are applied directly to the tooth, which can weaken its integrity over time, inlays and onlays are crafted to fit perfectly within the tooth's contours, providing a stronger and more conservative solution. Compared to crowns, which require extensive reshaping of the tooth, inlays and onlays offer a less invasive alternative that still provides substantial reinforcement and protection.

Longevity and durability are also key considerations when opting for inlays and onlays. Made from high-quality materials like porcelain or composite resin, these restorations are highly resistant to wear and can last significantly longer than traditional fillings. With proper care, a well-crafted inlay or onlay can endure for many years, offering a durable solution that maintains both the functionality and appearance of the affected tooth. This combination of strength, durability, and aesthetic appeal makes inlays and onlays a preferred option for many dental restorations.

The application of inlays and onlays begins with an initial consultation and diagnosis. During this appointment, the dentist conducts a thorough examination of the affected tooth, often using X-rays or digital imaging to assess the extent of decay or damage. This step is crucial for determining if an inlay or onlay is the appropriate treatment compared to alternatives such as fillings or crowns.

Once the treatment plan is confirmed, the procedure typically unfolds over two separate visits. During the first visit, the dentist will prep the tooth by numbing the area and removing any decayed or damaged portions. An impression of the tooth is then taken to ensure a precise fit for the inlay or onlay, which is custom-made in a dental laboratory. A temporary filling may be placed to protect the tooth until the second appointment.

The second visit occurs about one to two weeks later, once the custom inlay or onlay is ready. During this appointment, the dentist will remove the temporary filling, thoroughly clean the tooth, and then bond the inlay or onlay to the tooth using strong, lasting dental adhesive. The dentist will make necessary adjustments to ensure a perfect fit and comfortable bite. Patients can expect minimal discomfort throughout the process and can often resume regular activities shortly after each visit, making inlays and onlays a convenient and effective solution for restoring tooth integrity and aesthetics.

Immediately after getting inlays or onlays, it's crucial to follow your dentist’s aftercare instructions to ensure proper healing. Avoid eating or drinking for at least one hour until the anesthesia wears off to prevent accidental biting or burning. Stick to soft foods for the first 24 hours, and avoid chewing on the treated side to minimize discomfort. Maintain good oral hygiene by gently brushing and flossing around the treated area, but be careful not to irritate the gum tissue.

For long-term maintenance, continue practicing excellent oral hygiene: brush twice daily with a fluoride toothpaste and floss once a day to prevent plaque buildup. Regular dental check-ups every six months are essential for monitoring the condition of your inlays or onlays. Avoid chewing hard foods, ice, or using your teeth to open packages, as these can cause damage. Visit your dentist immediately if you notice any signs of issues, such as persistent pain, increased sensitivity, or if the inlay or onlay becomes loose or falls out. Early intervention can prevent more complicated problems and ensure the longevity of your restoration.