Dental Inlays and Onlays

Cavities are second only to colds as being the most common disease. They can occur if you eat sugary foods and those made of simple carbohydrates (such as white flour and white rice), which stick to teeth and attract bacteria that turn into plaque, the sticky film which eats away at the enamel, the protective outer layer of teeth. Beverages that are acidic, such as carbonated sodas and coffee, also erode the enamel, letting bacteria into the softer dentin layer beneath it or even the vulnerable inner core.

If you are diligent about brushing twice a day for two minutes after breakfast or lunch and then dinner, as well as flossing after your last snack, you might prevent cavities from taking hold. However, this is not easy to do, especially if you have crowded teeth or find it hard to adequately clean the ones in the back of the mouth. Sometimes cavities don’t even cause pain and can be so tiny that you may not be aware one has developed unless your dentist has recently done a physical exam and taken an x-ray.

For small cavities, fillings are the traditional remedy to prevent the cavity from becoming so large that it causes a tooth to die and need to be extracted. But fillings can only cover a relatively small area. Inlays and onlays are for those that are too large for a filling to be effective (and are not so large that a dental crown needs to cover the top of the whole tooth). Inlays fit over the grooves of teeth, while onlays cover their cusps (points).

Both have to be custom-made to fit your tooth and your dentist will first remove the cavity, then make a mold of the area to be filled, use it to create a temporary inlay/onlay, and send it to a top dental laboratory to craft. When you return, it will be fitted and tested to make sure it is comfortable or needs slight adjustment. An anesthetic is usually not needed for the procedure, but can be used when requested. 

The material for both inlays and onlays can be a tooth-colored composite resin, which is less expensive, but also less durable, than cosmetic dental porcelain, which can be matched to the exact shade of your other teeth and is more stain resistant. Often, dental insurance will cover at least part of the cost.
Once you have an inlay or onlay placed, continue to brush and floss as always, but with special attention to the areas around them, using an interdental brush and a dentist-approved mouthwash to fight periodontal bacteria. You should also come in at least twice a year for a full dental exam and a professional cleaning by the dental hygienist.