Dental Inlay: When a dental inlay is your best option?

The ideal candidate for dental inlays will have too much damage or decay to be treated using a filling, but enough healthy teeth left that a crown is unnecessary. Dental inlays are made from materials that can last for a period ranging from anywhere half a decade to a couple of decades. However, there is no guarantee that dental inlays will touch these extremes, although we can always preserve the inlays. At the end of the day, there are different factors that determine how long will dental inlays last. Any type of inlay that bears a lot of wearing and tearing, without proper care will succumb quickly. You have a higher chance of making the dental inlay last long, with cleaning on a regular basis.

What are inlays and onlays?

Also known as ‘indirect fillings’, dental inlays and onlays are a way to restore teeth that are too badly decayed or chipped for fillings. They are a durable, strong and natural looking solution that is more conservative and easier to fit than a crown and are most commonly used for the back teeth of your mouth.

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Unlike fillings, inlays and onlays strengthen the tooth structure instead of weakening it. They are specifically made to fit exactly into your tooth cavity and are bonded into place, making them strong and hard wearing. After the procedure, the tooth can bear 50-75% more chewing force than before.
Inlays are bonded within the centre of the tooth, within the cusps (the raised points on your teeth) or rounded edges of your tooth.nOnlays are like inlays, but they are used when the damage to your teeth cover one or more than one cusps and cover the entire chewing surface of your tooth. If cared for properly, dental inlays and onlays can last up to 30 years.
If the damage to your tooth is extensive, dental crowns may be a better option for your teeth. However, as crowns require a large amount of tooth structure to be removed, dental inlays and onlays are a much preferred and less damaging procedure as only a minimal amount of the tooth is removed.

The Dental Filling Vs The Inlay

In theory, these two can often be used interchangeably, but inlays are typically reserved for much larger cavities. They both involve removing the existing cavity with a drill and filling that empty space, but how that space is filled is where they primarily differ. With a filling, an amalgam or composite material is used to fill the space, and it’s a much quicker process, involving only a single visit.

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With an inlay, the space is filled with a single, solid piece that is usually fabricated in a lab, although they can sometimes be made in-office, and they are typically made out of a material like gold or ceramic. The inlay must be made precisely to the shape and size of the empty space, otherwise food and bacteria will enter the space, resulting in further decay. The upside to an inlay is that they do not contract to the same degree as a filling after being placed, so there is less chance of the restoration failing for that reason, or creating a gap between the filling and the surrounding tooth structure. Inlays also create a tougher and theoretically more durable surface for use when chewing, and as such, an inlay should be more reliable long term, although the data on that is mixed and inconclusive.

Dental Inlays and Onlays Procedure

The procedures for both dental inlays and onlays are also similar. Your dentist may require you to come in for two dental visits to complete the treatment, or may be able to complete your treatment in just one visit using CEREC technology. The traditional two-visit procedure is as follows:

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• Cleaning and preparing. This involves using special dental instruments to remove damaged or decayed parts of your tooth. You will be numbed with a local anesthetic before your dentist begins the procedure to ensure you are comfortable. They will also be conservative with the removal process to help you keep as much of your natural tooth structure as possible.
• Tooth impression. Your dentist will create the mold or impression by positioning dental putty over your prepared tooth. The mold will then be sent to a dental lab for inlay or onlay fabrication.
• Temporary tooth restoration placement. Because you will have to wait to receive your inlay or onlay, your dentist will place a temporary filling to protect your tooth between appointments.
• Cleaning and preparing. During your second visit, your dentist will clean and prepare your tooth for your permanent inlay or onlay. They will first remove your temporary filling and then fit your tooth restoration in place.
• Fitting and bonding. Your dentist will ensure that your inlay or onlay is fitted perfectly before they bond it to your tooth with dental cement. Once the fit looks and feels right, your tooth restoration will be expertly polished until it is as smooth as your natural teeth.

Same-Day CEREC Inlays & Onlays Procedure

If your dentist suggests CEREC inlays and onlays, they will be able to complete your entire procedure in just one visit. Going this route will allow you to skip the temporary filling and wait time between appointments. Here’s what to expect during a same-day CEREC inlay or onlay procedure:
• Your dentist will clean and prepare your tooth and take a digital impression of your smile. A virtual model of your tooth will then appear on a computer screen.
• Based on the model, your dentist will construct your inlay or onlay using special software that will then send your impression to an in-office milling machine.
• Your ceramic inlay or onlay will then be milled right in office while you wait. It will be sized, shaped and shaded to match your natural smile.
• Your inlay or onlay will then be fitted onto your tooth and bonded once it fits perfectly.

How long does it take to get an inlay or onlay?

It typically takes two appointments for the inlays and onlays treatment to be completed and to be finally bonded to the damaged area of the tooth.

How will I feel after the treatment?

There will probably be a little discomfort after the inlay or onlay procedure, and the new tooth surface may feel a little odd, but you soon get used to the new tooth surface and how it feels and looks in your mouth. The tissue around the treated tooth may feel sore or sensitive, but this should subside in a couple of days. If you do feel some discomfort, you can take over-the-counter pain medication to alleviate the symptoms.

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Aftercare for Dental Inlays and Onlays

Following your procedure you may experience tissue sensitivity around your tooth. This should be minimal and only last one or two days. Over-the-counter pain relievers may be all you need to find relief. Your dentist should also provide detailed aftercare instructions which may include the following:
• Avoid hot and cold beverages and sticky foods while you’re still numb or experiencing sensitivity.
• Pay close attention to your bite. If your tooth doesn’t feel right or your bite feels off, contact your dentist right away to avoid possible complications.
• Once numbness or soreness subsides, take care of your new inlay or onlay just as you would the rest of your teeth. Avoid chewing on overly hard or sticky foods to prevent damage or cracks, brush your teeth twice a day, floss once a day and see your dentist for regular teeth cleanings and exams. Doing so will allow you to enjoy your inlay or onlay for many years.

What are the factors affecting the lifespan of inlays?

The oral hygiene habits of any patient are undeniably the biggest factor behind the lifespan of dental inlays or any other dental fixtures. Your regular cleaning practices will determine how long your inlays will stand the test of time. Again, this thing can vary from person to person, and it does make a big difference at the end. A dental inlay requires proper care, alongside professional assistance on a frequent basis.
Apart from flossing and brushing your teeth several times a day, one can extend the lifespan of their inlays by avoiding certain habits such as grinding and clenching their teeth. Some people even have a habit of grinding teeth, when they are sleeping. In such a case, one should visit a dentist to sort out a solution.

What to expect for dental inlay lifespan?

No one can give an exact or even approximate measure of time for which the dental inlay will last. The minimum that you can expect in the worst case is around 5 years, and at bare maximum, it can last for up to 20 years. However, these numbers are just assumptions based on historical data, hence don’t get surprised if they last for only a couple of years or for your lifetime. On an average, inlays can last for around a decade, which is fair enough for the price you pay.


What Will Happen At The Initial Consultation?

At the initial consultation, the dentist will determine whether the tooth can be repaired using an inlay or onlay procedure or whether a more extensive treatment, such as a crown, is needed. Once it is determined that an inlay or onlay will suffice, a decision needs to be made as to the material. Gold has the longest track record, but it does tend to be less esthetical appealing. Porcelain and tooth coloured composite resin are two other choices of material for the new tooth structure. Because both of these materials are tooth coloured they are particularly favoured if the tooth is visible or if esthetic results are an important goal.

How Much Pain Is There?

Local anaesthetic takes care of the pain that would occur with the preparation of the tooth. Residual pain after the preparation or after cementing the structure in place is relatively rare and can usually be taken care of using over-the-counter medicines such as aspirin.


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