Dental inlays and onlays are gold, composite, or porcelain materials used to repair moderately damaged or decayed teeth. Dentists use dental inlays and onlays to restore a tooth that is too damaged to repair with a filling but not damaged enough to need a crown. Dental inlays and onlays save the healthy portion of an injured tooth and provide strength and stability for normal chewing. A dental inlay is placed in the center area of the tooth. A dental onlay is placed on the inside and outside areas, or points, of a tooth. Dental inlays and onlays are also called indirect fillings or partial crowns. They are a less aggressive and usually less expensive treatment option than full crowns. Placing a dental inlay or onlay is generally considered safe, but there are risks and potential complications. It is only one method used to repair damaged or decayed teeth. Discuss all of your options with your dentist to understand which options are right for you. Types of dental inlays and onlays Dental inlays and onlays can be made of the following materials: Composites (resins) include powdered glass-like material and acrylics. Composite inlays and onlays are more cosmetically pleasing than metal because they match the tooth’s color. Metal, typically gold, but other metals may be used as well. Dentists may use metal inlays or onlays in back teeth, or molars, because of metal’s strength and durability. Today, gold is used less often than in the past because it is less cosmetically pleasing than other types of inlays and onlays. Porcelain matches the tooth’s color. Your dentist may recommend a dental inlay or onlay for conditions including: Cracked or chipped teeth that cannot be repaired with a dental filling but do not require more extensive procedures to repair, such as a root canal and/or dental crown. Tooth decay (cavities, dental caries) that occurs when bacteria in your mouth produce an acid that damages the teeth. Dentists can often repair minor to moderate decay with a dental filing. Moderate to severe or deep decay may require a dental inlay or onlay or crown to save the function of the tooth. The following dental providers perform dental inlay or onlay procedures: General dentists prevent, diagnose and treat diseases and conditions of the teeth, gums, mouth, and associated structures of the jaw and face. Pediatric dentists specialize in caring for the dental needs of children and teens. Prosthodontists specialize in restoring damaged teeth with crowns, bridges and other devices. Your dental inlay or onlay procedure will be performed in a dental office or clinic. The procedure varies depending on the type of tooth and inlay or onlay but generally includes these steps: You will sit in a reclining position in the dentist chair and wear a clear shield over your eyes. The shield protects your eyes from spraying liquids and dental instruments. Your dentist will inject a local anesthetic into the gums near your tooth. The anesthetic numbs pain during the procedure. Your dentist may apply a painless topical anesthetic to numb the gums partially before the injection. Your dentist will use a drill to remove the damaged part of your tooth. He or she will file down certain parts of your tooth to prepare it to stick to the inlay or onlay materials. Your dentist will make a mold (impression) of your tooth. Your dentist uses the impression of your teeth to make a customized inlay or onlay that fits correctly. Some dentists have equipment to make inlays and onlays in their offices. In this case, your dentist will make and place your inlay or onlay during the same visit. Some dentists send dental impressions to a lab that makes inlays and onlays. In this case, your dentist will cement a temporary inlay or onlay in your tooth until your permanent one is ready. The temporary inlay or onlay lasts for a few weeks or months. You will return to the dentist’s office within a few weeks. Your dentist will remove the temporary inlay or onlay and place your permanent one with strong and permanent cement. Your dentist will smooth and polish the inlay or onlay to ensure a comfortable bite and so that it will not scrape your mouth or tongue. Will I feel pain? Your comfort and relaxation are important to you and your care team. You may feel brief sharp pinches when your dentist injects your gums with local anesthetic. Ask your dentist if your gums can be partially numbed with a painless topical anesthetic before the injections. You may also feel pressure as your dentist prepares your tooth to receive an inlay or onlay. Take a few long, deep breaths to help yourself relax. Tell your dentist if any discomfort does not pass quickly. Complications of a dental inlay or onlay are uncommon, but any procedure involves risks and the potential complications that may become serious in some cases. Complications can develop during the procedure or your recovery. Risks and potential complications of a dental inlay or onlay include: Allergic reaction to the inlay or onlay Anesthetic complications, such as allergic reaction and nerve or blood vessel injury Expansion and shrinkage of a composite inlay or onlay, which can which can damage the inlay or onlay and the tooth Decay in the tooth if the seal of the onlay or inlay is lost or damaged Injury to the mouth or gums Sensitivity to heat and cold in the affected tooth. This can occur when an inlay or onlay is lost or damaged and exposes tooth structure and nerve endings. Reducing your risk of complications You can reduce the risk of certain complications by: Following activity, dietary and lifestyle restrictions and recommendations before your inlay or onlay procedure and during recovery Informing your dentist if you are nursing or if there is any possibility that you may be pregnant Notifying your dentist immediately of any concerns after the procedure such as pain, fever, and difficulty chewing Taking your medications exactly as directed Telling all members of your care team if you have any allergies, especially any metal allergies if your dentist is using a metal inlay or onlay You are an important member of your own dental care team. The steps you take before your dental inlay or onlay procedure can improve your comfort and outcome. There is generally no special preparation needed, but it is important to do the following before any procedure: Answer all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times. Take medications exactly as directed. Tell your care team if there is any possibility of pregnancy. Questions to ask your dentist Having a dental inlay or onlay procedure can be stressful. It is common for patients to forget some of their questions during a dentist’s office visit. You may also think of other questions after your appointment. Contact your dentist with concerns and questions before your procedure and between appointments. It is also a good idea to bring a list of questions to your appointment. Questions can include: How long will the procedure take? When will I go home? What are my options for types of inlay or onlay materials? What restrictions will I have after the procedure? When can I return to eating, work, and other activities? What medications will I need before and after the procedure? How will you treat my pain? When should follow up with you? How should I contact you? Ask for numbers to call during and after regular hours. Knowing what to expect can help you get back to your everyday life as soon as possible. How will I feel after the dental inlay or onlay procedure? Your mouth, gums and tongue may feel numb for a few hours after your dental inlay or onlay procedure. This is because the local anesthetic will take time to wear off. You may also feel some gum tenderness. Your tooth may be more sensitive than usual to cold and heat for a few days or weeks after your procedure. Tell our dentist if these symptoms worsen or continue longer than a couple weeks because they can be a sign of a complication. When can I go home? You will probably go home and resume most of your normal activities immediately after a dental inlay or onlay procedure. Your dentist may instruct you to wait to eat and drink until after your anesthetic has worn off and you can feel your mouth and tongue again. This will help prevent you from accidentally biting your mouth or tongue. When should I call my dentist? It’s important to keep your follow-up appointments after a dental inlay or onlay procedure. Call your dentist if you have any concerns between appointments. Call your dentist right away if you have: Bleeding Fever Pain in your gums or teeth Problems biting or chewing Seek immediate medical care if you have itching, hives, mouth or tongue swelling, or breathing problems, such as shortness of breath, difficulty breathing, labored breathing, or wheezing. This may be due to a rare allergic reaction to the anesthetic or the onlay or inlay. How might a dental inlay or onlay affect my everyday life? A dental inlay or onlay can save a moderately damaged or diseased tooth and help protect it from further damage. Dental inlays and onlays can also preserve an attractive healthy smile. Dental inlays and onlays require daily dental care just like a normal tooth. An inlay or onlay will not protect your tooth from decay. You should continue to brush your teeth twice a day and floss every day. Inlays and onlays experience wear and tear and may eventually need replacement. However, most of them have a long life, as much as ten to thirty years. Visit your dentist at least once or twice a year, or as recommended, for regular cleanings and check-ups to ensure that your inlay or onlay is intact and working well.