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All the below content has been written by Dr. Sandip Sachar. 

Dentist NYC: Porcelain Fillings, Inlays & Onlays

What is an inlay?

An inlay is a type of filling that is used to repair and restore teeth that are damaged due to tooth decay or trauma.  They are utilized when the deficit is too large for a regular filling.  It is different than a regular filling in that, it is custom fabricated from a mold of you tooth in a dental laboratory, and made out of more durable materials.  A regular filling is not made in a laboratory.  It is done by the dentist, chair side. An inlay is bonded in place on the tooth, once received from the laboratory.  An inlay is more conservative than using a dental crown in that, more of the natural tooth needs to be removed when a crown is used. 

Diagram picture of porcelain inlay filling

Why would I need an inlay?

Inlays are used to treat a large deficit in a tooth due to tooth decay, cavities and trauma to the tooth.  When the deficit is too large that a regular filling is unable restore the strength of the tooth necessary for normal function, an inlay is indicated.  It is utilized when enough of the tooth is able to be saved, such that a crown is not necessary.  With a crown, more of the natural tooth needs to be removed.  The inlay restores the tooth to his normal function, shape, size and appearance.  It also seals the tooth to prevent decay.

What is the difference between an inlay and an onlay?

An inlay and an onlay are very similar.  They are both made in a laboratory, out of durable materials, that are utilized to restore a tooth that is damaged due to trauma or decay.  Both inlay and onlay seal the tooth and restore the normal size, shape, function and appearance of the tooth.  The difference between an inlay and onlay is, what part of the tooth is being restored.  An inlay is utilized when the filling lies within a tooth, surrounded by healthy tooth structure on all sides. An onlay is utilized when one or more of the outer parts of the tooth are affected by decay or trauma and needs to be filled also. Sometimes the decay or trauma affect all sides of the tooth, necessitating the need for a crown.  For these reasons, the onlay is slightly more extensive and larger than the inlay and more conservative than a crown.  Our dentists will always decide which of these procedures are best for our patients.

How is an inlay made?

The first step in preparing the tooth for an inlay, is to remove all the decayed parts of the tooth, and remove any bacteria, tartar and plaque.  Once the tooth is filed to remove all decayed areas, a mold of the tooth is made.  This mold is then sent to the dental laboratory to fabricate the inlay.  After the mold is done, a temporary filling is placed to seal the tooth until the inlay is ready to be inserted and bonded.  Our dentists will decide on what materials to use in order to make the inlay, and they will instruct the dental laboratory.  On the subsequent visit, the temporary filling is removed.  The inlay is evaluated to make sure it fits perfectly.  Assuming it fits, it is then bonded permanently onto the tooth.

What is an inlay made of?

Inlays can be made out of gold, resin, ceramic or porcelain.   As always, at Sachar Dental NYC, we only the least toxic materials possible for all of our procedures.

How is an inlay inserted into my mouth?

The temporary filling that is placed at the previous visit is first removed.  The remaining tooth is then thoroughly cleaned to remove all bacteria and plaque.  Once the tooth is thoroughly cleaned, the inlay is evaluated to make sure it fits perfectly.  Assuming it does fit, it is then permanently bonded to the tooth.

What to expect after an inlay procedure?

On your first visit, the decayed or broken part of the tooth will be filed and removed.  You will be advised to not eat anything until the anesthesia wears off.  A temporary filling will be placed on your tooth to seal it against decay.  We advise patients to avoid eating on that side as much as possible while the temporary filling is in place, and until the the permanent inlay is bonded to the tooth.

At your next visit, after removal of the temporary filling, the inlay will be permanently bonded to the tooth and you will be given instructions.  Depending on what materials are used to bond the inlay to your tooth, you may be instructed to not to eat anything on that side for anywhere from 1-24 hours.  If we use anesthesia locally, you will be instructed not to eat until the anesthesia wears off.  Normally, there will be no pain or discomfort after the inlay is placed.  The next time the inlay is evaluated will be at your biannual checkup.

How long will my inlay last?

Under normal conditions, an inlay lasts up to 15 years or more.  In some patients who grind or clench their teeth, they may damage the inlay and need to have it replaced sooner.  If you grind or clench your teeth, we recommend getting a nightguard to protect the inlay.

What should I do if my inlay does not feel right?

If you feel discomfort or problems with an inlay, or if your bite does not feel even, we recommend coming in for an evaluation.  When we see you, we will examine the inlay to make sure that is not loose, or have any other problems.  We may take x-rays to look for decay underneath the inlay, or problems with the nerve in the root of the tooth.  We will also evaluate the biting surface to make sure that it is even.

What should I do if my inlay falls out?

If your inlay falls out, we recommend coming in as soon as possible for an evaluation.  Leave the inlay out of your mouth to prevent a choking hazard, or possibly swallowing the inlay . An inlay that has fallen out leaves the tooth underneath it exposed.  When you come in for evaluation, we will first identify what are the underlying factors that led to the inlay falling out.  By identifying the underlying factors, we can prevent the inlay from falling out again in the future.  We will then assess whether or not your inlay can be reused.  If it can be reused, it will be bonded back in place.  If there is decay underneath the inlay that caused it to fall out, the decayed part of the tooth will need to be filed and removed.  If this is the case, a new inlay will need to be ordered from the laboratory in order to fit the new shape of the tooth after filing.  We will then insert a new temporary filling and have you come back for the inlay to be inserted and bonded again.

Can I get additional tooth decay or cavities underneath an inlay?

Normally, an inlay is able to permanently seal the tooth to prevent decay.  However, plaque that is left after brushing and flossing may cause further decay of the same tooth.  If this is the case, the inlay may need to be removed and replaced with a new one.  To prevent this, we recommend daily brushing and flossing daily, and coming in twice per year for your normal dental checkups and professional dental cleanings.

Is an inlay used after a root canal?

In some cases, after a root canal procedure is performed, the remaining tooth may be able to be sealed and restored using an inlay.  Not all root canals procedures require a crown.  We will determine if enough of the natural tooth remains such that an inlay is enough to seal it, restore its normal shape, size, strength and function.

How do I care for my inlay?

After receiving an inlay, your home care does not change.  We still recommend brushing and flossing daily.  We also recommend coming in twice per year for your normal dental checkups and professional dental cleanings.  We also recommend a healthy diet including many fruits and vegetables and avoiding sugary foods.

What is the cost of an inlay in Midtown Manhattan?

At Sachar Dental NYC, we have a one-time charge of $1,200 for an inlay.  This one-time cost includes the actual cost of the materials that make the inlay, and all the work done to fabricate and insert it.  This includes all visits related to the inlay.  It will be a minimum of 2 visits for the inlay.  This one-time cost includes removing any decayed part of the tooth and reshaping it to accept the inlay.  It also includes the cost of the temporary filling that will be inserted.  It also includes the next visit in order to bond the inlay to the tooth.  If any further follow-up visits for the inlay are necessary, they will also be included.

Will my dental insurance cover an inlay?

Most PPO dental insurances plans will cover the cost of an inlay at 50-80%.  Before you come into our office at Sachar Dental NYC, we always check your dental insurance benefits so that we are able to inform you of what your out-of-pocket costs will be, prior to performing any procedures.  On the day of your inlay procedure, you will only be responsible for your percentage of the costs.  We will then submit the claim to your dental insurance.  We will accept payment directly from your insurance company for the insurance portion. 

Can I use flexible spending dollars or a medical savings account for these charges?

Yes, you may be able to use your medical savings accounts or flexible
spending dollars to cover charges related to your treatment.  At the
time of your service, we will provide you with all the necessary
documentation and receipts.

Do you offer payment plans for treatment?

At Sachar Dental NYC, we offer interest free financing through Lending
Club and Care Credit.  In 15 minutes, we will let you know if you are
approved for interest-free financing.  These options will enable you to
make payments over the next 12-18 months without any interest charged.

Why are we the best dentists in New York City for an inlay?

At Sachar Dental NYC, we always use the most conservative and least invasive approach to solving your problems.  We only do an inlay procedure if it is absolutely necessary.  If we are able to preserve more of the natural tooth, we will not do an inlay procedure, but rather perform a regular filling.  As always, at Sachar Dental NYC, we use the least toxic materials available.  We pay a little extra for premium materials and do not pass these costs on to our patients.  We only use the best dental laboratories available in New York City.  When it comes to making the decision to perform an inlay versus a regular filling, an onlay, or a crown, we have the extensive education and experience necessary to make the best choices.  And, when some cases are more complicated, we have a prosthodontist specialist in our office with over 20 years of experience, to handle these more complex cases.

Onlays

What is an onlay?

An onlay is custom type of filling that is made in a dental laboratory. They are used to repair and restore teeth that are damaged due to tooth decay or trauma.  Onlays are used when the deficit is too large such that a regular filling is unable to provide enough strength.  An onlay is utilized when one or more of the outer parts of the tooth are affected by decay or trauma and need to be filled. It is different than a regular filling in that, it is custom fabricated in the dental laboratory, out of durable materials, from a mold taken of the tooth.  A regular filling is not made in the laboratory, and is made by our dentists chairside.  After it is received from our laboratory, an onlay is bonded in place on the tooth.  An onlay is more conservative than using a dental crown in that, more of the natural tooth needs to be removed when using a crown.  An onlay is similar to a partial crown.

Diagram picture of porcelain onlay filling

What is the difference between an onlay and an inlay?

An inlay and an onlay are very similar.  They are both made in a laboratory, out of durable materials, that are utilized to restore a tooth that is damaged due to trauma or decay.  Both inlay and onlay seal the tooth and restore the normal size, shape, function and appearance of the tooth.  The difference between an inlay and onlay is, what part of the tooth is being restored.  An inlay is utilized when the filling lies within a tooth, surrounded by healthy tooth structure on all sides. An onlay is utilized when one or more of the outer parts of the tooth are affected by decay or trauma and needs to be filled also. Sometimes the decay or trauma affect all sides of the tooth, necessitating the need for a crown.  For these reasons, the onlay is slightly more extensive and larger than the inlay and more conservative than a crown.  Our dentists will always decide which of these procedures are best for our patients.

Why would I need an onlay?

An onlay is used to treat a large deficit in a tooth due to tooth decay, cavities and trauma to the tooth.  When the deficit is too large that a regular filling cannot adequately restore the necessary strength of the tooth, an onlay is indicated.  It is utilized when enough tooth is able to be saved that a crown is not necessary.  With a crown, more of the natural tooth needs to be removed.  The onlay restores the tooth to its normal function, shape, size, strength and appearance.  It also seals the tooth prevent decay.

How is an onlay made?

The first step in preparing the tooth for an onlay is to remove all decayed parts of the tooth and to clean any bacteria, tartar and plaque.  Once the tooth is filed to remove all decayed areas, a mold of the tooth is made.  This mold is then sent to our dental laboratory to fabricate the onlay.  After the mold is done, a temporary filling is placed to seal the tooth until the onlay is ready to be inserted and bonded.  The dentist will decide what materials to use in order to make the onlay, and instruct the dental laboratory.  On the subsequent visit, the temporary filling is removed.  The onlay is evaluated to make sure it fits perfectly.  Assuming that it fits, it is then bonded permanently onto the tooth.

What is an onlay made of?

Onlays can be made out of gold, resin, ceramic or porcelain.   As always, at Sachar Dental NYC, we only the least toxic materials possible for all of our procedures.

How is an onlay inserted into my mouth?

The temporary filling that is placed at the previous visit is first removed.  The remaining tooth is then thoroughly cleaned to remove all bacteria and plaque.  Once the tooth is thoroughly cleaned, the onlay is evaluated to make sure that it fits perfectly.  Assuming that it does fit, is then permanently bonded to the tooth.

What to expect after an onlay procedure?

On your first visit, the decayed or broken part of the tooth will be filed and removed.  You will be advised to not eat anything until the anesthesia wears off.  A temporary filling will be placed on your tooth to seal it against decay.  We advise patients to avoid eating on that side as much as possible.

At your next visit, after the temporary filling is removed, the onlay will be permanently bonded to the tooth, and you will be given instructions.  Depending on what materials are used to bond the onlay to your tooth, you may be instructed not to eat anything on that side for anywhere from 1-24 hours.  If we use anesthesia locally, you will be instructed to not to eat anything until the anesthesia wears off.  Normally, there’ll be no pain or discomfort after the onlay is placed.  The next time the onlay is evaluated, will be at your biannual checkup.

How long will my onlay last?

Under normal conditions, an onlay will last up to 15 years or more.  In some patients who grind or clench their teeth, they may damage the onlay and need to have it replaced sooner.  If you grind or clench your teeth, we recommend getting a nightguard to protect the onlay.

What should I do if my onlay does not feel right?

If you feel discomfort or problems with an onlay, or your bite feels uneven, we recommend coming in for an evaluation.  When we see you, we will examine the onlay to make sure that is not loose, or have any other problems.  We may take x-rays to look for decay underneath the onlay or problems with the nerve in the root of the tooth.  We will also evaluate the biting surface to make sure that it is even.

What should I do if my onlay falls out?

If your onlay falls out, we recommend coming in as soon as possible for an evaluation.  Leave the onlay out of your mouth to prevent a choking hazard, or possibly swallowing the onlay . An onlay that has fallen out leaves the tooth underneath it exposed.  When you come in for evaluation, we will first identify what are the underlying factors that led to the onlay falling out.  By identifying the underlying factors, we can prevent the onlay from falling out again in the future.  We will then assess whether or not your onlay can be reused.  If it can be reused, it will be bonded back in place.  If there is decay underneath the onlay that caused it to fall out, the decayed part of the tooth will need to be filed and removed.  If this is the case, a new onlay will need to be ordered from the laboratory in order to fit the new shape of the tooth after filing.  We will then insert a new temporary filling and have you come back for the onlay to be inserted and bonded again.

Can I get additional tooth decay or cavities underneath an onlay?

Normally, an onlay is able to permanently seal the tooth to prevent decay.  However, plaque that is left after brushing and flossing may cause further decay of the same tooth.  If this is the case, the onlay may need to be removed and replaced with a new one.  To prevent this, we recommend coming in twice per year for your normal dental checkups and professional dental cleanings.

Is an onlay used after a root canal?

In some cases, after a root canal procedure is performed, the remaining tooth may be able to be sealed and restored using an onlay.  Not all root canals procedures require a crown.  We will determine if enough of the natural tooth remains such that an onlay is enough to seal it, and restore its shape, size, strength and function.

How do I care for my onlay?

After receiving an onlay, your home care does not change.  We still recommend brushing and flossing daily.  We also recommend coming in twice per year for your normal dental checkups and professional dental cleanings.  We also recommend a healthy diet including many fruits and vegetables and avoiding sugary foods.

What is the cost of an onlay in Midtown Manhattan?

At Sachar dental NYC, we have a one-time charge of  $1,200 for an onlay.  This one-time cost includes the actual cost of the materials that make the onlay, and all the work done to insert it.  This includes all visits related to the onlay.  It will be a minimum of 2 visits for an onlay.  This one-time cost includes removing any decayed part of the tooth and reshaping it to accept the onlay.  It also includes the cost of the temporary filling that will be inserted.  It also includes the next visit in order to bond the onlay to the tooth.  If any further follow-up visits for the onlay are necessary, they will also be included.

Will my dental insurance cover and onlay?

Most PPO dental insurances plans will cover the cost of an onlay at 50-80%.  Before you come into our office at Sachar Dental NYC, we always check on your dental insurance benefits so that we are able to inform you what your out-of-pocket costs will be, prior to performing any procedures.  On the day of your onlay procedure, you will only be responsible for your percentage of the costs.  We will then submit the claim to your dental insurance.  We will accept payment directly from your insurance company for the balance. 

Can I use flexible spending dollars or a medical savings account for these charges?

Yes, you may be able to use your medical savings accounts or flexible
spending dollars to cover charges related to your treatment.  At the
time of your service, we will provide you with all the necessary
documentation and receipts.

Do you offer payment plans for treatment?

At Sachar Dental NYC, we offer interest free financing through Lending
Club and Care Credit.  In 15 minutes, we will let you know if you are
approved for interest-free financing.  These options will enable you to
make payments over the next 12-18 months without any interest charged.

Why are we the best dentists in New York City for an onlay?

At Sachar Dental NYC, we always use the most conservative and least invasive approach to solving the problem.  We only do an onlay procedure if it is absolutely necessary.  If we are able to preserve more of the natural tooth, we will not do an onlay procedure, but rather perform a filling.  As always at Sachar Dental NYC, we only use the least toxic materials available.  We pay a little extra for premium materials and do not pass these costs on to our patients.  We only use the best dental laboratories available in New York City.  When it comes to making the decision to perform an onlay versus a filling, an inlay, or a crown, we have the extensive education experience necessary to make the best choices. And, when presented with more complicated cases, we have a prosthodontist specialist in our office with over 20 years of experience to handle these more complex cases.

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