Cavities and loss of tooth structure are the main reasons for patients to show up at the dental office. Your dentist uses different techniques or measures to fill the cavity and restore the lost tooth structure. Other filling materials like silver fillings and gold fillings have been used in the past. The filling is done if there is a cavity on the tooth surface. A crown is given when major tooth structure is lost. But what can be given if the tooth structure loss is more than a cavity? Placing an entire crown might require excessive removal of the existing natural teeth. Hence the middle ground options came into existence. Those are inlays and onlays. WHAT IS AN INLAY? An inlay is an intra-coronal restoration. They are used to fill a large area of ​​damage inside the tooth and are not recommended if the damage or decay extends beyond the cusps. WHAT IS THE DIFFERENCE BETWEEN A FILLING AND AN INLAY? A filling covers only a small defect in tooth structure, whereas an inlay helps fill the defects larger than cavities that do not extend beyond cusps.

WHAT DOES A DENTAL INLAY LOOK LIKE? A dental inlay looks like a partial crown shaped in the form of the cavity. It is custom-made extra-orally to fit into the cavity. It can be made with different materials like gold, composite, ceramic, or metals. An impression of the shape of the cavity is first recorded in wax and then processed in the laboratory with the required material to form the inlay. This custom-made inlay is bonded to the tooth structure using resin cement. WHAT IS AN ONLAY? An onlay is very similar to an inlay, but it is an intra-coronal restoration that is partly intra-coronal and partly extra-coronal that covers all the cusps in posterior teeth. It looks similar to a partial crown but extends only till cusps and not beyond that. It can be made with different materials like gold, composite, ceramic, or metals. DOES GETTING AN INLAY HURT? Usually, these restorations are given when a large amount of tooth structure is damaged. Removal of a large amount of decayed tooth structure might lead to sensitivity as we are approaching the pulp cavity with nerves and blood vessels. Your dentist will numb you with a local anesthetic while preparing the tooth, removing caries, and bonding the inlay till the procedure is completed, and this anesthetic wears off after 2 hours. If the tooth is already root canal treated, you might not even feel the pain anyway throughout the procedure. So, there would not be any need for anesthesia during the process. If any discomfort continues for a day or two, your dentist prescribes some over-the-counter painkillers.

WHAT ARE THE ADVANTAGES OF INLAYS AND ONLAYS? Since dentistry is progressing towards minimally invasive dentistry, inlays and onlays are a welcome choice. The advantages of these are: ● Requires less destruction of natural tooth structure ● Provides strength to the tooth and restoration as the most amount of natural tooth is preserved ● More esthetic as a natural tooth can be saved in esthetic zones ● Ceramic inlays and onlays are biocompatible and chemically inert Patient selection is equally important for inlays and onlays as they are not indicated for all. They are contraindicated in patients with: ● High caries index ● Poor oral hygiene ● More loss of tooth structure ● Bruxism patients ● Improper enamel and dentin formation in syndromic patients Getting an inlay or onlay is a technique-sensitive procedure. The decision of suggesting an inlay or onlay entirely depends on your diagnosis and treatment plan given by your dentist. So, consult your dentist to get more information regarding this minimally invasive procedure.