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Treating Tooth Decay: Onlay vs. Inlay In Houston, TX

Inlays and onlays are considered the perfect middle ground between dental fillings and crowns.

By Jennifer
Photography by Pete

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When cavities first appear, dentists typically recommend a tooth filling to repair the damage. Dental fillings use composite resin bonded to the tooth’s surface to build it back to its old shape and size. This works great for smaller dental caries, but more significant and severe cavities will need something larger and more robust than a dental filling. Crowns are a popular option because they fully restore the tooth’s entire enamel, using durable materials like porcelain and metal. However, what happens if your cavity is too large for a filling and too small for a dental crown?

Dental inlays and onlays are these alternative options. They are solely used to restore the decay damage on the biting surface of molars and premolars. These back teeth have four cusps that form pits and fissures notorious for trapping food, plaque, and other debris. As long as the cavities stay confined to these top biting surfaces, our dentists can treat them with a filling or onlay. Inlays and onlays are typically made of a special dental composite, porcelain, or gold. However, porcelain is the most popular due to its strength and natural appearance.

What Is The Difference Between An Onlay And Inlay?

A dental inlay is used when tooth decay remains localized only to the areas between the back teeth’s cusps. It is the first step up from a dental filling. Our dentists will recommend an inlay when standard bonding can’t sufficiently restore the tooth’s shape, size, and function—at least not without compromising the tooth’s strength and durability. Inlays are designed to fit in the small pit or valley at the tooth’s center without impacting the cusps.

When the damage to the tooth is more extensive and has involved even one of the cusp of the tooth, you will instead need a dental onlay. Onlays are used to treat larger cavities that reach one or more cusps of the tooth, along with any decayed areas between them. They are also sometimes called partial crowns. This is because they can sometimes encompass the entirety of the tooth’s top surface if the cavity doesn’t reach further down the tooth towards the gum and roots. Onlays are typically recommended as a more conservative option for dental crowns, saving more of the tooth’s structure overall and better preserving your natural tooth.

How Long Does An Inlay Procedure Take?

Unlike a cavity filling, inlays typically take two visits to complete. The first appointment is the lengthiest, usually taking about an hour. During this visit, the cavity and decay are removed just like your dentist would with a filling. An impression of your mouth is made, which will be sent to a lab to create your inlay. In the meantime, a temporary restoration is placed on the tooth. This placeholder keeps your tooth protected against food, plaque, and decay while your permanent inlay is made. This usually takes a week or two.

Once the inlay is ready, you will come in for your second and last appointment. This visit is often only 10 to 20 minutes long. Your dentist will place the final restoration, making any necessary adjustments before gluing the restoration in place with dental cement or bonding. The inlay’s surface is then polished smooth. With porcelain and composite inlays, your restoration will blend in with the rest of your tooth as well as recreate your tooth’s original feel and shape. The dental onlay process is virtually the same, only using a different restorative piece.

Does Getting An Inlay Hurt?

Not with our dentists in charge. Before starting the inlay process, we will use a numbing agent around the tooth to keep you from feeling a thing throughout the procedure. Our dental office even makes applying the local anesthetic as painless and stress-free as possible. We use innovative tools like Dentapen and Dentalvibe to mask the injection, so many patients never notice until their mouth is already turning numb. For patients who are particularly nervous or anxious about dental appointments, we also offer dental sedation, like nitrous oxide, to keep you relaxed and pain-free.

Are Dental Onlays Necessary?

If your dentist suggests an onlay (or an inlay), then it is necessary. A standard dental filling won’t be enough to fully repair the damage done to your tooth. Inlays and onlays not only protect and rebuild the tooth but prevent any further infection. They also strengthen the tooth structure while restoring functions like chewing and speech. While our dentists could perform a crown procedure, this would require removing more of the tooth’s structure than is needed. The tooth would be decay-free, but a dental crown would certainly be overkill.

However, without professional treatment, the cavity will only continue to worsen, wreaking havoc on your smile. Tooth decay won’t stay confined to the tooth’s enamel. Instead, it will burrow further into your tooth, attacking the sensitive inner tissues keeping your tooth alive and healthy. Once the central dental pulp becomes involved, inlays, onlays, and even dental crowns won’t be enough. You’ll need a root canal. Eventually, enough of the tooth can be infected that it dies. Without an immediate root canal, the only remaining option is to extract the tooth.

Our dentists want to treat your cavities as early as possible to keep your treatments more conservative and help your teeth stay healthier. Please seek professional treatment at the first appearance of cavity and tooth decay symptoms:

  • Toothache that lasts more than a day
  • Visible pit in the tooth’s surface
  • White or dark spots on the tooth
  • Tooth pain when chewing or biting down
  • Sharp tooth sensitivity to hot and cold foods
  • Lingering sensitivity or tooth twinges to sweets
  • Chronic bad breath
  • Pimple on the gums

If your tooth suddenly becomes numb after having a persistent toothache, please schedule an immediate appointment with our Houston team. This is a sign that the tooth is in danger of dying (or it has already died). With quick and responsive treatment, our dentists may be able to save your tooth even in the last tooth decay stages with an emergency root canal.

How Long Do Inlays And Onlays Last?

Inlays and onlays are built to last a long time because they are made from sturdier and more durable materials than fillings. On average, inlays and onlays have a typical lifespan of 10 to 30 years, making them just as long-lasting as dental crowns. In comparison, most composite dental fillings need to be replaced after 5 or 10 years. However, exactly how long your inlay or onlay lasts depends on the material used and your own care.

  • Composite is on the shorter end of the spectrum, with lifespans of up to 15 or 20 years
  • Porcelain is more durable, often lasting 20 to 30 years with good care
  • Gold is the longest-lasting of any dental material, often lasting 30 or more years—some gold restorations can last a lifetime

Maintaining impeccable oral hygiene is the key to ensuring you get the most out of your onlay or inlay. This means flossing daily and brushing your teeth twice a day with a fluoridated toothpaste and soft-bristled toothbrush. We recommend limiting the amount of sugary and starchy foods and drinks you have because they’re good at attracting oral bacteria and dental plaque. You should also see your dentist for a routine cleaning and exam at least once every six months. Together, these all keep plaque and bacteria from building up and creating more cavities that put your restoration’s survival at risk.

If you think you may have a dental cavity and need immediate tooth decay treatment, please call us to schedule an appointment with our team today at (832) 916-4144. Our dentists will perform a thorough examination to see whether an inlay or onlay is the right choice for your smile.

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