Fillings vs. Inlays
In a sense, these are almost the same, except that the term “inlay” is typically used for very large cavities. Both solutions involve the removal of a pre-existing cavity and then filling that resulting in empty space, but the process of filling is how they ultimately differ. With a filling, the cleaned out empty space is filled with either an amalgam or composite material, and it’s a pretty quick process done in only one dental visit at Dr. Dennis Wells, of Nashville Center for Aesthetic Dentistry.
With an inlay, the drilled-out space is filled with one solid chunk of material that is designed in a dental lab, typically built with gold or ceramic. The completed inlay must precisely fit the shape and size of the empty space so that food and bacteria can’t get into space and cause more decay. One advantage of an inlay is that they do not shrink after being installed, as some fillings do, so there is less chance of failure. Inlays are a tough, durable surface for chewing, and are thought to be more reliable long term.
The major deterrent for dentists using inlays is the fact that many dental insurance policies will not pay for them. Instead, companies will try to lower the inlay to a filling category and only pay that lesser price, which someone ends up paying. Inlays are usually kept for patients with no insurance, who understand the charges and are willing to pay out of pocket.
Onlays vs. Crowns
Both dental crowns and “onlays” are used to repair very large areas of decay that fillings and inlays will not fix due to the size. The unique feature of an “onlay,” as opposed to an “inlay,” is that it can cover the cusp of a tooth, with an inlay only filling in between the cusps. The procedure is similar as the material is drilled and removed first, then an onlay is manufactured to the perfect size and shape of the empty space. Even more drastic, a crown will cover the whole tooth structure above the gum line.
An onlay is a less assertive restoration than a crown, if possible since less tooth material needs to be drilled out in order to attach it. But while the cost structure is similar, an onlay is a little cheaper than a crown. The onlay is always the favored solution when possible, as it requires less tooth loss. However, onlays are more difficult than crowns and require advanced skills from the dentist.
Again, cost becomes an issue when deciding between onlays and crowns. Similar to inlays vs. fillings, dental insurance is less likely to cover an onlay procedure. But since companies will cover a crown, because it is more widely chosen by dentists, onlays are left as a specialty procedure for more skilled dentists and patients with means to pay out of pocket for an expensive procedure.