Inlays and onlays are precision restorations used to repair teeth that are too damaged for a simple filling but don’t necessarily require a full crown. Made from strong, tooth-colored materials such as porcelain or ceramic, these restorations are custom-crafted to fit the exact contours of the prepared area. An inlay sits within the cusps of a back tooth to restore the central chewing surface, while an onlay extends to cover one or more cusps when more support is needed.
Unlike traditional amalgam or direct composite fillings, inlays and onlays are fabricated outside the mouth—either in a dental laboratory or by an in-office CAD/CAM milling unit—and then bonded into place. That off-site fabrication allows for exceptional precision in shape and fit, which translates into a seal that resists leakage and staining. Because they replace only the damaged portion of the tooth, inlays and onlays preserve more natural structure than crowns.
At Contemporary Dentistry we recommend these restorations when conserving healthy tooth tissue is a priority. They bridge the gap between small restorations and full-coverage crowns, offering a middle path that balances strength, longevity, and aesthetics for many patients.
It begins with a thorough evaluation: a visual exam, radiographs when needed, and a discussion about function and esthetics. The dentist assesses the remaining tooth structure, checks for cracks or decay, and determines whether an inlay or an onlay will provide the most durable, conservative result. Digital imaging or intraoral scans are commonly used to document the tooth and plan the restoration.
Once treatment is planned, the tooth is prepared by removing decay or weakened material and shaping the area for a precise fit. If the practice uses a milling system, a restoration can often be designed and produced the same day. When a laboratory fabrication is chosen, accurate impressions or digital files are sent to the lab so technicians can craft a restoration that matches the tooth’s anatomy and color.
Before the permanent piece is placed, the dentist verifies fit, occlusion (bite), and shade. The restoration is then permanently bonded using modern adhesive techniques that create a chemically durable union between the ceramic and the tooth. The result is a restoration that functions like a natural tooth and blends with adjacent dentition.
Porcelain and advanced ceramics are the most common materials for inlays and onlays because they mimic the optical properties of natural enamel and resist staining. These materials are biocompatible and can be matched precisely to the patient’s tooth color for a seamless appearance. For back teeth where strength is paramount, lithium disilicate and other reinforced ceramics are frequently selected for their excellent fracture resistance.
Compared with traditional fillings, ceramic inlays and onlays offer superior wear characteristics and color stability. They are less prone to shrinkage than direct composite restorations, which helps maintain a tight marginal seal over time. When bonded correctly, a ceramic inlay or onlay can actually increase the structural integrity of a compromised tooth by distributing chewing forces across a larger, reinforced area.
Because multiple materials and fabrication methods are available, the dentist will recommend the option that best balances longevity, appearance, and conservation of tooth structure. This individualized approach ensures the restoration performs well under everyday function while remaining cosmetically pleasing.
Ideal candidates include people with moderate tooth damage from decay, large failing fillings, or fractures that are too extensive for a simple filling but insufficient to require a crown. Patients who prioritize preserving as much natural tooth as possible often choose inlays and onlays because these restorations remove less healthy tooth structure than crowns.
Good overall oral health is an important consideration; the surrounding gum and bone should be healthy, and any active decay or gum disease must be addressed before placing a restoration. Patients who grind their teeth or place excessive force on restorations may still be candidates, but the dentist will evaluate risk factors and may recommend protective measures such as night guards.
People concerned with aesthetics—particularly those who want a metal-free solution—often prefer ceramic inlays and onlays because they provide a natural look without the dark margins associated with metal-based restorations. Ultimately, candidacy is determined by clinical examination and a treatment plan tailored to the patient’s needs and goals.
Once an inlay or onlay is bonded, normal chewing can generally resume shortly after the procedure, though patients are advised to avoid very hard foods for a short period while the bond fully stabilizes. Routine oral hygiene—brushing twice daily with fluoride toothpaste and daily interdental cleaning—remains the foundation for long-term success. Regular professional checkups allow the dentist to monitor the restoration and surrounding tooth structure.
Inlays and onlays are durable, but like all dental work they benefit from periodic evaluation to detect wear, marginal breakdown, or recurrent decay early. Addressing problems promptly helps extend the life of the restoration and protects the underlying tooth. If bruxism or other functional issues are present, the dentist may recommend adjunctive treatments to protect the restoration and neighboring teeth.
With attentive care and routine dental maintenance, many patients experience years of reliable function and esthetic satisfaction from their inlays and onlays. The combination of conservative preparation, precision fabrication, and strong adhesive bonding creates a restoration that supports both oral health and a natural-looking smile.
In summary, inlays and onlays provide a conservative, long-lasting solution for teeth that fall between filling and crown restoration. They preserve natural tooth structure, offer excellent esthetics, and can strengthen compromised teeth when placed using modern adhesive techniques. If you’d like to learn whether this treatment is right for you, please contact Contemporary Dentistry for more information.
Inlays and onlays are indirect restorations designed to repair teeth with damage that is too extensive for a simple filling but does not require a full crown. An inlay fits within the cusps of a back tooth to restore the central chewing surface, while an onlay extends over one or more cusps when additional coverage is needed. These restorations are fabricated from strong, tooth-colored materials and are bonded to the prepared tooth for a precise fit.
Because they replace only the damaged portion of the tooth, inlays and onlays preserve more natural structure than crowns and often provide a more conservative long-term solution. The off-site fabrication process, whether at a dental laboratory or via an in-office milling unit, allows for excellent contouring and marginal accuracy. Many patients choose these restorations for their combination of strength, longevity and esthetics.
Fillings are placed directly into a prepared cavity and are best for small to moderate areas of decay, while crowns cover the entire visible portion of a tooth and are used when a tooth is heavily damaged. In contrast, inlays and onlays are indirect restorations that are custom-made to fit the prepared area, offering a level of precision and fit that direct fillings cannot match. They occupy the middle ground between fillings and crowns by conserving healthy tooth structure while providing greater strength than a large filling.
The decision among a filling, an inlay/onlay, or a crown depends on the amount of remaining tooth structure, the location of the tooth, and functional demands such as chewing forces. The dentist evaluates these factors during a clinical exam and may use imaging or digital scans to help determine the most conservative and durable option. When used appropriately, inlays and onlays can extend the life of a compromised tooth while maintaining a natural appearance.
The process begins with a comprehensive evaluation that includes a visual exam and radiographs or digital imaging as needed to assess decay, cracks and overall tooth structure. During treatment, the dentist removes any decay or weakened material and shapes the preparation for an accurate fit, then captures impressions or digital scans of the prepared tooth. Depending on the chosen workflow, the restoration is either milled in-office for same-day placement or sent to a dental laboratory for fabrication.
When a laboratory is used, a temporary restoration may be placed while the custom piece is created to protect the tooth and maintain function. At the placement visit the dentist checks fit, occlusion and shade, then bonds the restoration using adhesive techniques that create a durable union with the tooth. Final adjustments are made to ensure comfortable chewing and a natural bite before you leave the office.
Common materials for inlays and onlays include porcelain and advanced ceramics such as lithium disilicate, which are prized for their esthetic properties and strength. These materials mimic the optical qualities of natural enamel, resist staining and provide reliable wear characteristics in the mouth. In some cases, composite resin or metal alloys have been used, but ceramic restorations are generally preferred for their color stability and biocompatibility.
The material chosen depends on the tooth's location, the amount of chewing force it will bear and the patient’s esthetic goals. Reinforced ceramics offer excellent fracture resistance for back teeth, while highly esthetic porcelains can be matched precisely for visible restorations. Your dentist will recommend the material that best balances longevity, function and appearance for your specific situation.
Ideal candidates are patients with moderate tooth damage from decay, large failing fillings or small fractures that are not extensive enough to require a crown. Candidates should have reasonably healthy surrounding gum and bone tissue, and any active decay or periodontal issues should be addressed before a restoration is placed. Patients who prioritize conserving natural tooth structure and prefer a metal-free, natural-looking restoration often benefit from inlays and onlays.
People who habitually grind or clench their teeth may still receive inlays or onlays, but the dentist will assess functional risk and may recommend protective measures such as a night guard. Final candidacy is determined by a clinical examination and discussion of restorative goals, and the treatment plan is tailored to preserve tooth structure while ensuring durable function. When in doubt, the dentist can explain alternatives like crowns and why they might be recommended in more severe cases.
Yes, many practices use chairside CAD/CAM systems to design and mill ceramic inlays and onlays during a single appointment, allowing for same-day restorations. This workflow eliminates the need for a temporary restoration and speeds treatment by producing a custom-fit piece while you wait. When a laboratory fabrication is selected, the process typically requires two visits—one for preparation and impressions and another for final bonding once the restoration returns from the lab.
Not every case is suitable for same-day milling; complex occlusal relationships, shade matching or multiple-unit cases may still be sent to a skilled laboratory for optimal results. Your dentist will explain the recommended workflow based on clinical needs and the goal of achieving a precise, long-lasting restoration. Both approaches aim to deliver excellent fit, function and appearance.
The lifespan of an inlay or onlay depends on factors such as the material used, the patient’s oral hygiene, chewing habits and the quality of the initial placement. Ceramic restorations placed with modern bonding techniques can provide many years of reliable function, often lasting a decade or longer when properly maintained. Regular dental checkups allow the dentist to monitor the restoration for wear, marginal breakdown or recurrent decay and address issues early.
Habits such as bruxism, chewing hard foods or poor oral hygiene can shorten the longevity of any restoration, so protective measures and preventive care are important. If signs of wear, rough margins or sensitivity develop, prompt evaluation can often preserve the underlying tooth and allow for repair or replacement before more extensive treatment is necessary. With attentive care, many patients enjoy long-term esthetic and functional benefits from their restorations.
Daily oral hygiene remains the foundation of long-term success for inlays and onlays, so brush twice daily with fluoride toothpaste and clean between teeth once a day using floss or interdental cleaners. Avoid using teeth to open packages or bite very hard objects, particularly during the first days after bonding while the restoration fully stabilizes. Attend routine dental visits so the dentist can evaluate the restoration, check margins and make minor adjustments if needed.
If you experience unusual sensitivity, roughness, or a change in your bite after placement, contact the dental office for an assessment rather than waiting for the next scheduled checkup. In patients who clench or grind, a custom night guard can protect the restoration and surrounding teeth from excessive force. Proactive care and prompt attention to changes can significantly extend the life of the restoration.
Bruxism increases functional stress on any dental restoration and can raise the risk of fracture or wear for inlays and onlays, so the dentist carefully evaluates grinding habits before treatment. If bruxism is present, material choice and restoration design can be adjusted to improve strength, and occlusal adjustments can help distribute forces more evenly. In many cases, inlays and onlays remain viable options when combined with protective strategies.
Common protective measures include fabrication of a custom night guard to reduce nighttime grinding and counseling about daytime clenching behaviors. The dentist may also recommend monitoring and periodic maintenance to detect early signs of wear. With appropriate risk management, patients who grind their teeth can often still benefit from the conservative advantages of inlays and onlays.
A consultation with a dentist is the best way to determine whether an inlay or onlay suits your needs; the evaluation typically includes a visual exam, radiographs or digital scans and a discussion of functional and esthetic goals. The dentist will assess the extent of existing damage, the condition of surrounding tissues and any risk factors such as bruxism that might influence material selection or treatment planning. Based on that assessment, the dentist will recommend the most conservative, durable option tailored to your case.
Contemporary Dentistry offers modern digital diagnostics and conservative restorative approaches that help inform this decision and create a personalized plan. If you are considering a restorative option that preserves tooth structure while improving function and appearance, schedule a consultation to review the findings and next steps. The result should be a clear recommendation aligned with your oral health goals and lifestyle.