Inlays
 When
a tooth is restored, there are frequently many options for the material used to
rebuild the tooth. Whatever the reason for restoring a tooth, the choice
of restoration material depends on esthetics, durability and strength, and cost
(time, money, and comfort).
RESTORATION
Most people know about fillings
and crowns (also known as caps). Because other methods exist to
repair a tooth, we refer to all these as restorations. |
A filling is packed into a tooth, whereas an
inlay is made outside your mouth and bonded or cemented into the tooth. A
filling is intended to "fill" a relatively small void, rather than
rebuild a significant part of a tooth. To rebuild and restore a larger
part of a tooth, a more effective choice has always been an inlay.
A inlay is a strong, durable
material made outside the mouth used to replace part of a tooth (can be
metallic or tooth-colored, we typically use a tooth-colored inlay) and is cemented or bonded once it is
constructed. An inlay fits like a puzzle piece into the tooth.
If one of the points (cusps) is replaced also, we refer to this as an
onlay. If the part of the tooth to be restored is even greater than a
filling, inlay or onlay can accomplish, then a crown
is used.
The process of making an inlay is similar to
getting a filling, but is a two part process. After your tooth is
anesthetized, the tooth is prepared (old filling removed - if present, decay
removed). A mold is made of this tooth (the mold usually includes adjacent
teeth and the teeth that this one bites against). From this mold the
laboratory
constructs your inlay (the color is matched to your tooth). While the inlay is being constructed you have a
temporary inlay material in your tooth. It takes about 10 working days
before your inlay is back from the laboratory. At the second
appointment, the inlay is bonded into your tooth (you may need to have anesthesia
and/or nitrous oxide if your tooth is sensitive). Once bonded into place your tooth is nearly
as strong as if it never had anything done to it.
| The temporary inlay is made
of a durable, semi-hard material. It should be comfortable to eat on
- if it is not, the bite may be too tall, please call. While
you have a temporary inlay in your tooth, you may chew and eat on it -
carefully. It is to your advantage not to eat anything very sticky
on it (gum, dried fruit, sticky candy, etc.), so that you don't dislodge
it. If a temporary inlay does come out, it can be placed back in the
tooth; however, it only fits in one way - you may want to call. |
Filling, Inlay and Crown
Compared
| |
FILLING |
INLAY |
CROWN |
| esthetics1 |
tooth color |
tooth color |
tooth color |
| durability |
** |
**** |
***** |
| cost2 |
* |
*** |
***** |
| 1 I use only
tooth-colored filling material (no silver amalgams); inlays and crowns can
be tooth colored, white or yellow gold - I typically use tooth-colored
materials 2 fillings and inlays have a
range of fees depending on the number of surfaces involved (from 1 to 4
surfaces) |
Actual Inlay Process
 |
To the left is the x-ray of a tooth with a
large tooth-colored filling that chipped. Underneath the chip was
some decay. The tooth was not sensitive; however, it was clear
that a filling alone could not restore the tooth with the strength and
durability to last for decades. |
|
Below are the pictures of the inlay
process for this tooth. |
 |
 |
| chipped filling |
tooth prepared
decay removed |
|
|
 |
 |
| temporary inlay |
final inlay |
NOTE: Dental insurance
typically only reimburses for the least costly method to restore a tooth (least
costly to the insurance company, short-term), regardless of the conditions or
professional recommendations. For example, in the tooth pictured
above, it could technically be filled, but this would not be strong enough or
durable enough to support the tooth long-term. In this instance the
insurance company reimbursed my client for what they would otherwise pay
towards a silver amalgam filling - which is the usual for what you could expect.
|
