Dental inlays and onlays are a type of indirect filling that’s made in a lab, similar to a crown. Because of their unique design and characteristics, inlays and onlays are only used in specific scenarios for certain types of patients. Not everyone qualifies for these “lab-made fillings” simply because of the criteria that there are for the teeth being treated.
Inlays vs. Onlays to Treat Specific Teeth
Inlays and onlays are made differently than dental fillings and crowns. As such, they only “work” for certain types of oral health needs. Depending on the area of the tooth that is damaged or decayed — and the extent of the damage that has occurred — a person will either qualify for an inlay or not. There typically is not much of a middle-ground.
For an inlay or onlay to be appropriate, the tooth involved will usually be one of the premolars or molars. These are the teeth that you do most of your chewing with, and they have a fairly rough or textured biting surface (as opposed to the front incisor teeth used for cutting.) An inlay or onlay will recreate the cusps (pointed edges) or fill in the grooves of those chewing teeth, which is why we typically don’t recommend them for the teeth at the front of your smile.
Extent of Tooth Damage
The primary requirement for an inlay or onlay is the extent of tooth damage that has occurred. There’s a reason why these restorations are frequently called a “three-quarter crown” and it’s because of the amount of tooth structure involved. Unlike a crown that covers the entire tooth underneath it, an inlay or onlay still requires a healthy amount of intact enamel in order to support the restoration.
Although inlays and onlays are smaller than crowns, they’re still much larger than a dental filling. And like fillings, they require the support of healthy enamel to keep them inside or on top of the tooth. It might be that a tooth is 1/3 to 1/2 of the way damaged and doesn’t qualify for a filling because it cannot support one. But something like a crown may be a bit excessive, given the amount of intact tooth structure that remains. It’s this fine balance where our experienced Long Island dentists will determine if your tooth qualifies for a dental inlay or onlay.
When an Inlay/Onlay is Better Than a Filling
A filling is perfect for modest structural needs like a small cavity. The filling is placed directly inside of a tooth after the decay has been cleaned out. But in instances where there is a large enough cavity that cleaning it out will only leave a small shell of enamel, a filling will simply cause the tooth to split in half once biting pressure is applied. In these instances, a dental inlay or onlay is preferred. The three-quarter crown nature of a lab-made restoration provides added structural support to the remaining tooth structure. And since it’s made in a lab, there will be a tighter, stronger fit.
When an Inlay/Onlay is Better Than a Crown
Crowns cover the entire visible portion of a tooth up to the gumlines. In most scenarios, they’re the only treatment option if you don’t qualify for a dental filling. But when you use a Long Island dentist who also offers inlay and onlay treatments, you have a more conservative and less invasive option to consider. Since crown treatments require reducing the height and width of tooth enamel for the “cap” to slip over the tooth, you are potentially removing otherwise sound tooth structure. Depending on the extent of healthy enamel that you still have, the more conservative option would be to place an inlay or onlay onto the tooth in place of a comprehensive crown. Going this route further extends the overall lifespan and functionality of the tooth because it delays major alteration of your tooth structure for several more years.
“Am I a Candidate for an Inlay?”
An “inlay” is different from an onlay, in that the majority of the restoration goes inside of the tooth and fills in the valley or grooves on the chewing surface. To qualify for an inlay, you’ll still need to have the “cusps” (pointed biting edges) of your tooth intact. The inlay itself is more to fill in the area between the cusps and inside of the tooth because of decay. There will need to be enough enamel left to surround the inlay and hold it into place on a daily basis.
“Am I a Candidate for an Onlay?”
Onlays are quite different than inlays, as they’re used to rebuild the cusps on the biting surfaces of your teeth. Onlays rest on top of and around the tooth, acting more like a partial crown than a dental filling. Although some people refer to inlays as “three-quarter crowns”, it’s onlays that are more of a partial crown restoration. The main requirement for an onlay is that there is enough tooth left that the entire structure does not need to be reduced for a “cap” to cover it.
Finding the Right Dentist
Not all dentists offer dental inlay and onlay services. In fact, inlays and onlays tend to be a less common restorative treatment among mainstream dental practices. One of the reasons being that some dentists feel it’s simply easier to be proactive by going ahead with a full-coverage dental crown. Especially since the treatment steps are nearly identical to one another.
At Sachem Dental Group, our Long Island dentist office is one of the few practices in Suffolk County to offer inlays and onlays. As a multi-specialty general dentistry clinic, we’re able to provide a wider range of comprehensive services, rather than pick and choose specific treatments to fit larger populations. Since inlays and onlays are better fitted for certain situations, we want to be sure to provide them as a service to patients who qualify.
To find out if you’re a candidate for a dental inlay or onlay, call Sachem Dental Group today. Our Suffolk County dentists are currently accepting new patients.