Fillings vs. Inlays and Onlays: A Thorough Comparison

How does a dentist treat a cavity

Solutions for Repairing Decayed Teeth

One thing no one wants to hear from their dentist is, “You’ve got a cavity.” But the good news is finding out you have a cavity is the necessary first step before taking action to repair the damage and prevent future decay from occurring.

After you and your dentist have discovered the problem, you can decide which treatment solution is best for your tooth. Because tooth decay is a prevalent issue, dentists have a few ways of repairing enamel damage. You’re probably familiar with dental fillings already, but inlays and onlays may be foreign terms to your ears.

Let’s dive into these three popular dental restorations and how they compare.

Dental fillings are popular for repairing simple cavities.

Dental fillings are likely the first thing to come to mind when you think of fixing a cavity in a tooth. They are the most frequently performed restorative dentistry service and are considered a general dental care procedure by most practices.

Dental fillings come in different materials. Silver amalgam fillings were quite popular in past decades, but modern dentistry now relies on beautiful tooth-colored composite fillings. Some people even choose to have their old silver fillings replaced with composite. 

The most apparent advantage of tooth-colored composite dental fillings is their natural appearance. However, composite is also favored because it bonds well to enamel and isn’t prone to expanding and contracting—two downfalls of old-school amalgam.

Another great thing about tooth-colored composite fillings is their versatility. Your dentist can use minimal amounts of this material to mend minor cavities without having to remove healthy enamel.

These advantages bring us to this question: If composite dental fillings are so great, why wouldn’t a dentist use them? The answer is pretty simple. Composite dental fillings are best for simple, smaller cavities.

If a tooth has more extensive decay, inlays or onlays are a much better choice.

Inlays and onlays can repair larger cavities better than fillings.

When tooth decay is left untreated, the cavity gradually expands. Eventually, the damage is extensive enough that a dental filling won’t be a reasonable solution. When a tooth needs more structural support, inlays or onlays are a great alternative to dental fillings.

Inlays and onlays are very similar in their design. While composite dental fillings require your dentist to sculpt the material into the cavity, inlays and onlays are milled from a more robust material, such as porcelain. Your dentist will then place the inlay or onlay onto the prepped tooth with a permanent dental adhesive.

The only difference between inlays and onlays is the part of the tooth they treat. Inlays lay within the tooth, between the cusps. Onlays lay over the tooth, covering the cusps. Onlays can cover so much of a tooth that they might be referred to as a partial dental crown.

This nickname for onlays brings us to the final question: How do dental crowns fit in?

Dental crowns provide support for advanced tooth decay.

In terms of restorative capabilities, inlays and onlays are between dental fillings and crowns. When teeth are too severely decayed for an inlay or onlay, but the dentist finds the tooth is savable, a dental crown is typically the best solution.

Dental crowns envelop a tooth with a durable material, such as porcelain or CEREC composite. It’s also common for a painfully decayed tooth to first go through root canal therapy before a dental crown. Even if the root canal only leaves a small hole, crowns are still used to add structural support to the now hollow tooth.

The average cavity probably won’t need a dental crown, but if your dentist does recommend a crown for a bad tooth, it’s vital to follow through with treatment. Dental crowns save teeth from extraction. If a tooth is in rough enough shape that a crown is necessary, skipping or prolonging treatment could mean extraction ends up being the only solution.

The Tooth Doc dentists will choose the perfect restoration for your oral health needs.

The Tooth Doc team is highly skilled at reading X-rays and performing thorough visual exams to determine whether a filling, inlay, onlay, or crown is the best long-term solution for your tooth. Our goal is to improve your oral health by choosing restorations that will last for years to come so you can maintain your beautiful smile and get the most value out of your dental care investments.

If you have a painful tooth or a tooth that has an obvious cavity, don’t delay treatment another day. Schedule an appointment with one of our dentists in Omaha, NE via phone or by online request.