Definition and Overview

Dental inlays are small fillings that are placed on the teeth's biting surface as a part of restorative treatment after the decayed part has been removed. The principle behind dental inlays is very similar to that of dental fillings, but instead of filling the hollow interior of the teeth, inlays are placed on top of the chewing surface known as cusps. Typically, the material used for inlays is gold, which is known to be strong, durable, and can last for many years. Gold, unlike silver or other types of fillings, does not tarnish and can withstand high biting pressure. Porcelain can also be used for inlays, especially the modern ones developed through digital technology.

Depending on the material used, inlays can last at least ten years. It is important to note that the kind of teeth involved, the amount of chewing force, and the patient's oral hygiene and dental visits can also play a large role in how long inlays can last.

Inlays are often used with teeth that are extensively decayed or fractured and are the best option when other kinds of restoration procedure, such as filling, will not serve the purpose.

Compared to a dental crown, inlays are relatively smaller; inlays are, however, bigger than normal fillings. If a bigger chewing surface needs to be covered with filling material, the procedure is called onlays.

Who should undergo and expected results

Patients with severely fractured or decayed teeth are the ideal candidates for inlays. This is because the extensive damage of their teeth will not be restored through other procedures such as composite or amalgam fillings. Direct restoration will only aggravate the condition and even compromise the structural integrity of the tooth being restored. Composite or amalgam fillings on such teeth cannot withstand the pressure, leading to more dental problems in the future.

After the procedure, the patient should be able to chew and put pressure on their teeth without feeling pain or discomfort.

How the procedure works

An initial visit with the dentist is required before the procedure is performed. This is to assess the extent of the damage and to ensure that inlays are the perfect solution to the problem.

The inlays are installed during the second visit. A local anaesthetic can be administered on the tooth and surrounding tissues to numb the pain. Patients can also choose other types of sedatives, such as nitrous oxide.

Direct inlays are made in the dentist's office, and can be placed on the patient's teeth in a single visit. However, if the damage is more extensive or if the patient needs more sophisticated (such as gold or dental-grade ceramic) fillings, indirect inlays are manufactured in a dental laboratory. Two visits are necessary for indirect inlays.

Before placing the inlay fillings, the decayed portion of the affected tooth will be removed. The dentist will then put composite resin on the tooth to get its shape. This composite resin mold can be hardened in a specialty oven.

Once the filling is hard enough, the dentist will cement the inlay on the patient's tooth. Polishing and filing will follow soon after, to ensure that the patient will not have an awkward bite.

For indirect inlays, the dentist will still need to perform decay removal and molding of the teeth shape. But instead of cementing the inlay right away, the patient will receive a temporary filling while the actual inlays are being manufactured in a laboratory.

After the procedure, the patient must maintain proper oral hygiene by regularly brushing and flossing. Regular visits to the dentist are also necessary.

Possible risks and complications

Inlays are generally safe, but some problems might occur if they are not applied properly. The dentist must make sure that the patient's mouth is completely dry before cementing the inlays in place because saliva can weaken the cement. Patients must also be aware that composite resin or porcelain inlays can crack.

Reference:

  • American Dental Association: "Dental Filling Options."
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