A hybrid between crowns and fillings

What are inlays and onlays?

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Inlays and onlays restore the damaged portion while preserving healthy tooth structure

Inlays and onlays are conservative dental prosthesis used to fix moderately damaged teeth. These restorations are used to fix teeth that are too far damaged for a filling, but not so badly where they require a full-coverage crown. Inlays and onlays are made in a laboratory or milling machine from ceramic. Placing an inlay or onlay on your tooth restores the damaged portion of the tooth while preserving healthy tooth structure. Inlays and onlays are durable, natural-looking, and very effective at restoring damaged teeth back to their original form. They also protect your tooth from cavity bugs, fractures, and bite forces.

What is the process of receiving an inlay or onlay?

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Inlays and onlays are made from ceramic in a laboratory or with a CEREC machine at your dentist

The process of receiving an inlay or onlay is very similar to receiving a traditional crown. First, your dentist will numb your tooth. Then, he or she will remove damaged tooth structure and cavities. Your dentist will take an impression or scan of your tooth. They will then make your inlay or onlay by sending it to their laboratory or using a CAD/CAM device to fabricate your restoration in-house. Once prepared, your inlay or onlay will be bonded to your tooth and permanently locked in place. In case you’re curious, here is the difference between what an inlay and onlay are:

Inlays

Inlays are very conservative restoration used to restore minimally damaged teeth. Placing an inlay on your tooth does not involve removing any outer tooth structure. Essentially, an inlay is fully confined within the tooth itself. Inlays leave your outer tooth walls fully intact to preserve maximum tooth structure.

Onlays

Onlays are larger than inlays and they are used to restore more severely damaged teeth. Onlays extend to cover at least one outer tooth wall. Whereas inlays are closer to fillings in terms of size and function, onlays are closer to full-coverage crowns. Onlays cover more of your tooth structure and leave just a small potion intact.

What is the difference between inlays and onlays versus a traditional crown?

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Inlays and onlays are more conservative than full coverage crowns and require less tooth removal

Think of inlays and onlays as more conservative crowns. Despite that, inlays and onlays are very similar to crowns in many ways, for example:

  • Inlays and onlays are made from ceramic, just like most traditional crowns
  • The procedure for receiving inlays, onlays and crowns is nearly identical
  • Inlays and onlays get bonded to your teeth the same way that a crown gets cemented onto your tooth

The only difference between these dental restorations is in how much tooth structure is removed. Inlays are the most conservative. Onlays are a bit larger and require more tooth removal. Full-coverage crowns are the largest of these restorations and cover the entire portion of tooth above the gumlines. Inlays and onlays make a great option for restoring damaged teeth that can’t be restored with a filling, but aren’t necessarily ready for a full-coverage crown either.

What are the benefits of inlays and onlays?

Inlays and onlays are used in place of traditional crowns to restore moderately damaged teeth. There are a few benefits which sets inlays and onlays apart from fillings and crowns. Here are some of the reasons so many dentists use inlays and onlays to restore your teeth in place of fillings and crowns:

Excellent tooth protection

Both inlays and onlays are made from durable ceramic. This makes them much stronger than traditional white fillings. White fillings are made from porous resins which easily break or leak under repeated chewing stress. Large white fillings are very likely to fail over time and lead to nerve damage or infection. Inlays and onlays do a much better job of protecting these teeth against cavities and chewing forces. They are also far less likely to leak the same way that white fillings do.

More conservative treatment

Inlays and onlays are much more conservative than full-coverage crowns. This means that they leave more of your original tooth structure intact, since inlays and onlays only cover the damaged portion of your tooth instead of your whole tooth. Being more conservative has several benefits. It reduces the likelihood of your tooth becoming sensitive, developing root canal infection, or breaking off and needing a dental implant.

Excellent durability

Inlays and onlays are both made from ceramic which makes them extremely durable and fracture-resistant. A well-designed inlay or onlay could easily last you decades, sometimes even a lifetime. They do a great job of protecting your teeth against cavities and fractures. Talk to your dentist to see if your tooth is a good candidate for receiving an inlay or onlay in place of a filling or crown.

When is it better to receive a traditional crown over an inlay or onlay?

Despite their many benefits, there are cases where placing a full-coverage crown is preferred to an inlay or onlay. Here are a few examples of cases better suited for a full-coverage crown than for an inlay or onlay:

Severely damaged tooth

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Severely damaged teeth are better restored with a full coverage crown that protects the whole tooth

The main benefit of inlays and onlays is that they are more conservative, thus preserving more original tooth structure. However, if your tooth is severely damaged, then there’s no need for a conservative restoration. Severely damaged teeth are better restored with a full-coverage crown that protects the entire tooth. Placing an inlay or onlay will leave these teeth vulnerable to further damage and could lead to infection or tooth loss. Talk to your dentist to see if your tooth is better suited for a conservative restoration like an inlay or onlay, or if a full-coverage crown is the better way to go.

Root canal treated teeth

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Root canal treated teeth need to be restored with full-coverage crowns

Root canal treated teeth should always be restored with a full-coverage crown instead of an inlay or onlay. Root canal removes blood flow to your tooth, as a result, your tooth becomes fragile and weak over time. Placing a full-coverage crown is a much better option to protect root canal treated teeth. Inlays and onlays don’t cover the entire tooth and lead to further damage to these teeth.

Multiple missing teeth

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Patients with missing teeth overcompensate by placing additional pressure on their remaining teeth

Avoid inlays and onlays if you have several missing teeth in your mouth. First off, missing teeth is a sign of failure to maintain proper oral hygiene. As a result, going with a stronger and more durable restoration is probably a better decision. Additionally, patients with missing teeth overcompensate by placing additional forces onto their remaining teeth. This added bite pressure causes inlays and onlays to fracture. Consequently, it’s best to go with full-coverage crowns when you have multiple missing teeth in your mouth.

Poor bite relationship

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Patients with a crossbite place 3 to 4 times as much forces onto their back teeth

Having a poor bite relationship places significantly more stress onto your remaining teeth. For example, those of you with a crossbite tend to place 3 to 4 times as much stress onto their back teeth. Similarly, having an underbite or overbite places additional stress onto your teeth. If you’re suffering from serious orthodontic issues that affect your bite, we usually recommended that you stay away from inlays and onlays. Full-coverage crowns are a much better option for patients with bite related issues.

Heavy teeth grinders

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Teeth grinders should also go with full coverage crowns

Grinding your teeth has the same effect as missing teeth or orthodontic malocclusion. Heavy teeth grinders place about 6 times as much stress on their teeth. This additional stress causes your teeth and dental restorations to break much more frequently. Again, it’s better to go with full-coverage crowns if you’re a heavy tooth grinder as inlays and onlays are likely to break within a few years. In fact, we recommend the heaviest tooth grinders to only consider restoring their teeth with gold or extra-strength ceramic, such as BruxZir, full-coverage crowns. Otherwise, you will find yourselves redoing your dental restorations over and over again!

Inlays and onlays in San Clemente, Orange County

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We offer inlays, onlays & crowns to help meet your functional and aesthetic needs

Give us a call today to you’re learn more about restoring your teeth with inlays and onlays. We are conveniently located in downtown San Clemente, Orange County. You can reach us at (949)481-2540 or book your appointment online today. Our dentist, Dr. Jazayeri, will help you decided if an inlay or onlay is a good treatment option or if you should go with a filling or crown instead. We offer customized ceramic inlays and onlays to help meet your functional and aesthetic needs. Don’t wait until your damaged tooth develops an infection or turns into a toothache! Give us a call to schedule your appointment today.

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If you’d like to learn more about different treatments related to inlays and onlays, click on the following links:

Definition of General Dentistry Terminology

Abscess (cyst)

A pus pocket containing harmful bacteria that forms around infected teeth. Teeth with abscess are considered infected and they either need root canal treatment or must be extracted.

Amalgam (silver filling)

Material used to fill dental cavities. Amalgam is silver colored and contains Mercury. As a filling material, Amalgam is durable and effective. However, there are some concerns about the safety of using Mercury to restore teeth.

Bicuspid tooth

Refer to premolar tooth please.

Canine tooth (cuspid or eye tooth)

A strong, pointed tooth with a single cusp used to direct other teeth as we chew side-to-side. Canine teeth are very strong and typically outlast all other teeth as we age. We have 4 total canines, teeth numbers: 6, 11, 22 and 27.

Cavity (decay)

A hole inside a tooth created by harmful cavity bugs. Dental cavities can cause slight tooth sensitivity, particularly to cold and sweets. They can also be asymptomatic. If left untreated, dental cavities infiltrate the tooth pulp and cause abscess and infection.

Composite resin (white filling)

Material used to fill dental cavities and broken teeth. Composite resin is safe, effective and matches your tooth color. Cosmetic dentists prefer using composite resins to other filling restoration material due to their natural appearance.

Crown (cap)

A large restoration that replaces the majority of your tooth structure above the gum line. Crowns are used to fix teeth which can no longer be salvaged with a simple filling. Crowns are typically made from gold, porcelain-fused-to-metal or ceramic material.

Decay

Refer to cavity please.

Deep cleaning (scaling & root planning)

A type of dental cleaning which focuses on removing plaque and tartar underneath your gum line. Deep cleanings are used to treat gum disease. Most deep cleanings are performed in multiple sessions and often times require anesthesia.

Dental cleaning

Teeth cleaning performed by your dentist or hygienist. Dental cleaning focuses on removing plaque and tartar which can’t be removed by brushing or flossing alone. Dental cleanings are categorized as simple cleaning or deep cleaning.

Dentin

The middle portion of your tooth which is located above the pulp and underneath the enamel. Unlike enamel, dentin has nerve endings which makes it sensitive to tooth decay.

Denture

Removable, false teeth used to replace your missing natural teeth. Dentures are made from pink and white acrylic. The pink portion secures your dentures in place and the white segment replaces your missing teeth. There are many different types of dentures including full dentures and partial dentures.

Enamel

The very hard outer portion of your tooth. In fact, enamel is the hardest tissue found in our bodies. Enamel protects your tooth from cavities and provides it with the strength to cut and chew food.

Filling

Material used by dentists to replace missing tooth structure. Fillings are used to fix dental cavities and broken teeth. Fillings are made from gold (mostly obsolete), Amalgam (silver filling) or composite resin (white filling).

Full Denture (Complete denture)

A set of false teeth which replaces all of your teeth in one arch. Full dentures are held in place by the suction they provide against your gum tissue. Full dentures are typically made from pink and white acrylic.

Gingivitis

The earlier stage of gum disease. Gingivitis is characterized by bleeding gums, bad breath and minor tooth sensitivity. If left untreated, gingivitis progresses to the more advanced stage of gum disease known as periodontitis.

Gum Disease (Periodontal disease)

Disease of the gums and jaw bone. Gum disease is caused by spread of harmful bacteria to your gum and jaw bone. Gum disease causes bleeding gums, bone loss and tooth loss. Gum disease is categorized as gingivitis and periodontitis.

Impacted Tooth

A tooth which is trapped underneath your jaw bone. Impacted tooth typically refers to wisdom teeth, although other teeth can also be impacted. Impacted wisdom teeth usually need to be removed. Other impacted teeth need to be removed, monitored or uprighted by your orthodontist.

Incisor tooth

The front most four teeth in your upper and lower jaw. Incisor teeth are used to cut food particles. We have 8 total incisors, teeth numbers: 7, 8, 9, 10, 23, 24, 25 and 26.

Infection

Spread of harmful bacteria into your tooth nerve. Once cavity bugs reach your tooth nerve, the tooth is now infected. Infected teeth can only be fixed with a root canal or you must remove the tooth completely.

Inlay

A type of crown which is a hybrid between fillings and crowns. Inlays are essentially conservative crowns which protect teeth similar to a crown but are conservative similar to a filling. Inlays are smaller than onlays and do not encompass your outer tooth walls.

Molar tooth

Teeth located in the back of our mouth which have four cusps. Molar teeth are large and used to crush food particles. We have 8 total molars, teeth numbers: 2, 3, 14, 15, 18, 19, 30 and 31. Additionally, some of us have 3rd molars or wisdom teeth which are teeth numbers: 1, 16, 17 and 32.

Nerve

Refer to pulp please.

Night guard

A device worn at nights to protect your teeth against grinding. Night guards help reduce tooth fracture, TMJ pain and headaches. There are two types of night guards, generic night guards which you purchase online or from a local pharmacy and custom night guards which your dentist makes for you.

Onlay

A type of crown which is a hybrid between fillings and crowns. Onlays are essentially conservative crowns which protect teeth similar to a crown but are conservative similar to a filling. Onlays are larger than inlays and encompass at least one or more of your outer tooth walls.

Partial Denture

A set of false teeth which replaces some, but not all, of your missing teeth. Partial dentures are held in place by anchoring to your remaining teeth as well as suction against your gum tissue. Partial dentures can be made from different material including metals, acrylic and flexible resin.

Periodontal disease

Refer to gum disease please.

Periodontitis

The more advanced stage of gum disease. Periodontitis is characterized by bone loss, major tooth sensitivity and loose teeth. If left untreated, periodontitis causes your teeth to loosen and fall out. Plus, the resulting infection can spread to the rest of your body and affect your overall health.

Premolar tooth (bicsupid)

Transitional teeth between our front and molar teeth. Premolars have two cusps and are used to crush food particles. They are also the teeth most commonly removed for braces treatment. We have 8 total bisupids, teeth numbers: 4, 5, 12, 13, 20, 21, 28 and 29.

Pulp (nerve)

The innermost tooth layer which lies underneath your dentin. Your tooth pulp contains nerves and blood vessels. When your tooth pulp becomes damaged this results in a toothache. Once this happens, you require a root canal treatment or must remove the tooth.

Pulpotomy

Pulpotomy is the equivalent of a baby root canal. It entails removing the nerve structure from infected baby teeth. Performing a pulpotomy eliminates toothache while allowing your child to keep the tooth itself in order to prevent potential orthodontic complications.

Root canal treatment

A procedure to remove infected tooth nerve to eliminate pain and infection. During root canal treatment your dentist will disinfect your tooth and replace the missing nerve with sterile material known as Gutta Percha. Root canal treatment eliminates pain and infection and allows you to keep the tooth.

Scaling & root planning

Refer to deep cleaning please.

Sealant

A preventive treatment used to protect children’s teeth. Dental sealants are placed on teeth with deep groves, typically molars, to protect them against tooth decay and infection. Sealants are very effective and safe and do not require any tooth structure removal.

Sedation

Techniques used to calm patients with anxiety during dental treatment. There are many different sedation techniques in dentistry such as Nitrous Oxide, oral conscious sedation, IV sedation and general anesthesia.

Silver filling

Refer to Amalgam please.

Simple cleaning

A dental cleaning performed in absence of gum disease. Simple cleanings typically entail basic tooth scraping and polishing, occasionally with Fluoride treatment. Most people require a simple cleaning once every 6 months, although if you’re suffering from gum disease you need one every 3 to 4 months.

Third molar

Refer to wisdom tooth please.

White filling

Refer to composite resin please.

Wisdom tooth (third molar)

Tooth which is located all the way in the back of your mouth. Wisdom teeth start erupting in your late teens or twenties. Not everyone has wisdom teeth. For those that do, there’s a high probability that you have to remove these teeth. Otherwise, they will cause pain, swelling and infection.

Oceansight Dental & Implants

General, Cosmetic & Implant Dentistry

Office of Ali John Jazayeri

106 S Ola Vista

San Clemente, CA 92672


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