What do you do with a rear molar that is too damaged to ignore but not damaged enough for a crown? Sounds like the beginning of a really bad joke, but there is a serious (and helpful!) answer. Dental onlays provide a solution to the problem of a tooth that has too much damage to leave alone but not quite enough for a crown.

What is an onlay dental procedure?

Sometimes teeth that have been filled or otherwise treated for cavity experience cracks, fractures, or loose filings. When this happens, there may still be plenty of healthy tooth left, but the tooth needs repair. In this case, a crown is too invasive and not necessary, but the damage cannot be ignored.

The solution to this dilemma is a dental onlay.

An onlay dental procedure restores the full biting surface of the rear teeth without removing excess tooth material. When a crown is applied, the dentist must remove the majority of the tooth surface above the gumline. If there is extensive decay and damage to the tooth, this makes sense. In all dental work, the best-case scenario is one that preserves as much of the healthy, natural tooth as possible.

A dental onlay strengthens the tooth while preserving whatever healthy tooth remains.

What can I expect during a dental onlay procedure?

The procedure for receiving a dental onlay is very similar to that of a crown.

On the first visit, your dentist will first clean out any decay or damage before taking an impression of the damaged tooth. The dentist sends this impression to a lab to create a customized dental onlay.

Porcelain onlays are the most common for their natural look and feel, as we prefer at AZ Dentist, but onlays can also be made from composite resin or gold. You will be given a temporary filling or crown while the onlay is created.

On the second appointment, your dentist will remove the temporary restoration and fit the permanent onlay to your tooth. Once the fit is correct, they will apply a dental adhesive before polishing and smoothing the onlay for the best bite and most natural finish.

Dental onlays strengthen the remaining tooth by up to 75%. This is a big improvement over metal fillings, which can actually weaken teeth.

What’s the difference between inlay vs. onlay?

Whether you receive a dental onlay vs. inlay depends on which part of your tooth needs to be repaired.

Dental onlays restore the full biting surface, while inlays only work if part of the biting surface is damaged. Your dentist can also help determine if an onlay vs. a crown is appropriate, mostly by assessing the extent of your tooth damage. When possible, an onlay is used to help preserve the natural tooth.

What the benefits of a dental onlay vs. crown?

Other benefits of a dental onlay vs. a crown include superior appearance and fit.

With regard to appearance, onlays may appear more natural than a full crown. Porcelain onlays resist stains better than some crown materials and can be virtually undetectable. The fit of dental onlays is perfect for tight spaces, such as between teeth where cavities often form.

Your dentist will generally choose the least invasive option to treat any damage caused by tooth decay, cracks, or fractures. A filling is the least invasive first step to treating tooth decay, followed in order by inlays, onlays, and crowns.

At AZ Dentist, we understand that each person is different and requires individualized treatment, so we work hard to find the best treatment approach for our patients. When it comes to choosing between dental onlay vs a crown, most dentists will choose dental onlays when possible for their superior strength, tooth preservation, and durability.

How long do dental onlays last?

As with most dental restorations, the durability of dental onlays depends on how well you treat them.

With proper brushing and flossing, and without any other damage, you can expect your onlay to last for 30 years (or more!).

How do I prepare for a dental onlay procedure?

Preparing for your dental onlay procedure begins with a conversation with your dentist (if you’re in Arizona, we are your Phoenix area cosmetic dentist!). They can give you details about the procedure and make sure you understand what to expect.

Each appointment for your dental onlays should last about an hour. The first appointment may be a bit longer due to the tooth preparation. There really isn’t much pre-operative care needed. If you are concerned about potential minor pain following the preparation of application of the onlay, make sure to stock up on softer foods and over-the-counter pain relievers, such as ibuprofen.

Patients who experience anxiety about dental procedures should discuss their options with their dentist before their appointment. In some cases where anxiety makes dental care challenging, dentists may prescribe a mild sedative or use nitrous oxide to relax patients.

What are dental onlay risks and side effects?

There are very few side effects associated with receiving dental onlays, but as with any type of dental restorations there are a few post-operative issues to be aware of.

Tooth sensitivity

You may experience increased sensitivity to hot and cold for the first few days after your appointment. This should go away on its own but an over-the-counter “sensitive teeth” toothpaste helps.

Soreness

In some cases where the preparation is more extensive, you may experience minor soreness. Eating a diet of soft foods for the first day or two after the appointment should help. Ibuprofen taken as directed will also ease any minor pain or inflammation.

Bacterial infection

In very rare cases, patients who have tooth material removed and filled may contract a bacterial infection in the tooth. This occurs when bacteria gets trapped underneath the onlay. Signs of infection include pain, fever, and swelling in the tooth. Infection is rare, but if you experience any of those side effects, talk to your dentist immediately for treatment.

Dental onlays may be the best treatment for a loose filling or a cracked tooth. Talk to the team at our Phoenix area dental clinic to see what’s right for you!