Do I need an onlay?

[carlg]

My dentist claims that instead of a crown or filling, an onlay is the best option for two of my upper teeth with cavities. He claims that the fillings would be too large and could cause damage to the teeth.

I cannot afford the 1100$ that these services are going to cost me.

Any suggestions??? Alternatives??

Thanks

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[Midoc]

Yes.

If your dentist says that the fillings would be too large that means that he would have to remove too much tooth structure and that would make the tooth structurally unsound and would likely lead to the tooth fracturing. At that point you would likely need a fixed bridge or implant, both of which are more expensive than onlays.

An onlay replaces the missing tooth structure and also covers part of the outer surface of the tooth to prevent fractures. It doesn't cover the entire outer surface so it isn't called a crown. You could think of it as a partial coverage crown though.

If you don't trust the dentist you are currently seeing you may want to get a second opinion.

 

[DrRob]

An onlay is healthier for the gingiva than a crown because the margins are more supragingival and therefore easier to keep clean.

Indirect restorations are a better option than direct because the contours of the restoration are created in a more controlled environment (out of the mouth and in the lab) - also they look better.

On the other hand you probably can find another dentist who will place a large composite restoration. If it were my mouth I'd want the onlay because they look better. The large filling may last, but there are more variables to be controlled than with the onlay.

 

[swiminh2o]

Can anyone explain what an inlay is? First of all, is there such a thing? It seems I remember hearing some dental students at one of my interviews talking about inlays and onlays..........? Just curious

 

[Dr.SpongeBobDDS]

It sounds like your dentist is looking out for you. I'm sure many dentists would have jumped right past the in-between option of an onlay and recommended a crown. If you are insistent you will without a doubt find a dentist who is willing to give you a gigantic filling first and then be more than happy to give you a crown when the filling fails in the not-too distant future. Remember, it's usually cheaper to fix it right the first time. 🙂

 

[aphistis]

Can anyone explain what an inlay is? First of all, is there such a thing? It seems I remember hearing some dental students at one of my interviews talking about inlays and onlays..........? Just curious

An inlay is a relatively conservative indirect restoration. the preparation for an inlay is contained within the original outline of the tooth (intracoronal), and only includes the occlusal & one or both interproximal surfaces. An onlay is a more aggressive restoration that covers the entire occlusal surface, & reaches over the cusp tips onto the lingual & facial surfaces (this is done to splint the cusps together to distribute occlusal force & prevent fracturing).

This page takes a long time to load, but it shows good examples of each:

http://users.eastlink.ca/~marksutherland1/OtherPages/Fine Gold Castings/Case 1.htm

The premolar on the patient's left has a gold inlay covering the occlusal & distal surfaces, & the two molars have onlays covering the entire occlusal surface, as well as both interproximal surfaces & reaching slightly over the tips of the cusps to provide support. Hope this helps!

 

[swiminh2o]

Aphistis,

Cool! Thanks man.