Problems

What exactly are inlays and onlays?

Inlays and onlays are an old fashioned, traditional method of restoring teeth that are not commonly used by dentists these days. They are known as indirect fillings. When the biting surface of the tooth is damaged and regular fillings are not adequate, inlays and onlays are used to fill crevices or repair extensive damage.

The difference between dental fillings and inlays and onlays is that dental fillings are directly done on the spot: they are placed in the tooth during your visit to the dentist, on the other hand, inlays and onlays have to be made in a dental laboratory; these are then subsequently fitted and chemically bonded to the damaged tooth by the dentist. Hence the name:Indirect fillings. Sometimes, inlays and onlays are used in place of full dental coverage crowns. As compared to full dental coverage crowns, they are better fitting, last longer, and look better.

The difference between inlays and onlays:

When the material is bonded within the center of the tooth, it is called an inlay. If the damage is more widespread and the new structure covers the whole chewing surface including one or more tooth cusps, the procedure is called an onlay.

The Benefits of using inlays and onlays:

Inlays and onlays are methods of repairing comparatively wide-ranging tooth decay or damage without really needing to replace the entire outer portion of the tooth as one would need to do with a crown. The amount of tooth material required to be removed is less, so inlays and onlays tend to be more conservative and esthetic as compared crowns.

The inlay and onlay procedures strengthen a tooth’s structure as compared to fillings where the structure may be weakened due to removing too much tooth material. Inlays and onlays are also likely to last longer than a regular filling, because the inlay or onlay material is custom made and bonded or fused to the tooth.

They offer a superior fit as compared to crowns, as the procedure tends to preserve as much of the healthy tooth as possible. This also safeguards the structure of the basic tooth and does not weaken it further and this in turn offers strength and stability to the teeth. An onlay can actually protect the weak areas of the tooth as the procedure does not require the complete reshaping of the tooth.

Esthetically, tooth color is retained offering better visual appeal, because inlays or onlays will not discolor as resin fillings usually do. Due to the fact that inlays and onlays are custom made and they fit better and do not shrink or change size during the curing process, this makes it a lot easier for you to clean or brush your teeth. Inlays seal the tooth better as compared to regular fillings and thus they keep out bacteria ensuring that there is no further decay taking place inside the tooth, under the filling.

The Procedure used for Inlays and Onlays:

Generally speaking an inlay or onlay procedure usually requires two or three dental visits to complete it.
In the first visit, the dentist makes a mold of your teeth as they exist in your mouth. This gives the dentist a basic structure to work from. A temporary sealant is placed on your damaged tooth. The mold is then sent to the laboratory where the technician will proceed to make an inlay or outlay as advised by the dentist, depending upon the extent of damage. The material to be used for the inlay or onlay is also selected in this visit.

The material selected to make the inlay or onlay depends on many factors such as the location and visibility of the tooth- if the tooth is situated at the back of the mouth and will not be visible when you smile or speak, then gold may be recommended as the material to be used, as this is long lasting, offers better protection and is smooth causing less abrasion to the opposing tooth. Whereas if you require an inlay or onlay for your front teeth, or teeth that will be exposed when you smile or speak then porcelain will be recommended as the best material as this can be made and colored to match your existing healthy teeth and will thus blend in better. If are a person who habitually grinds your teeth or have a very strong bite or chew heavily, or if you have malocclusion where your jaw is misaligned,then resin could be the best material for you. The dentist will help you make your best choice.

In the second visit, sometimes a temporary inlay or onlay could be fitted, if the final inlay or onlay is not yet ready. The final fitting would require a third visit. If the final inlay or onlay is ready, this will be fitted in the second visit. The temporary sealant will first be removed. When fitting the inlay or onlay the dentist will ensure that the restoration fits perfectly with all adjacent teeth, that there are no problems with malocclusion that might affect the fit of the inlay or onlay. When the inlay or onlay is fitted, it will be bonded to the tooth and then polished.

What lies in store for Inlays and Onlays?

Inlays and onlays as a restorative procedure are here to stay. They offer a fantastic amalgamation of excellent functional longevity and esthetic naturalness in addition to the fact that the materials used for making inlays and onlays continue to evolve, improve and become better, the procedure is not likely be replaced by another.

Factors to consider when selecting a Dentist for an Inlay or Onlay:

Not many dentists use the inlay and onlay procedure as there is no formal training for this procedure that any dental school offers. Dentists can get trained in the inlay and onlay procedure while working in close collaboration with the laboratory technicians. Sometimes the laboratory technician can be a part of your consultation or visit to the dentist offering his advice if the doctor has the technology of a video conference where the image of your teeth can be seen in real time by the dentist and the technician. Often the technician may be part of the fitting procedure, assisting the dentist, using the same conferencing technology.

What does the Inlays and Onlay procedure cost?

The expenses of the inlay and onlay procedure vary and depend upon many factors such as :

The fees of the dentist you have chosen. Renowned and experienced dentists may be more expensive as compared to a dentist who is just starting out and setting up his / her practice.
The location of the teeth that require the inlay or outlay in your mouth: For example, teeth in the front of the mouth are easier to prepare and work on as compared to molars or teeth located at the back of the mouth.
The size of the inlay or onlay required- smaller inlays or outlays are cheaper as compared to bigger ones.
The material that you select for the inlay or outlay- it goes without saying that a gold inlay or onlay will be more expensive as compared to porcelain. Conversely, porcelain inlays or onlays might require more craftsmanship and this might cost more in terms of labor than material.
Another factor influencing the price of inlays or onlays is your geographic location. If you live in a place where this technology is not available, you may need to travel to a place where it is. Or there may not be a local technician to fabricate the inlay or onlay, in which case it will need to be sent to a place where it can be fabricated and this will add to the cost.

Does Dental Insurance cover Inlays and Onlays?

The insurance policies and procedures differ from company to company. Inlays and onlays could be classified under ‘basic’ or ‘major’ service by the insurance company.

In the basic category the usual procedures such as dental cleanings, dental fillings, and routine services may be covered. Some insurance companies might have a pre-set limit for these services. You will have to verify from the company what these are. In case the dental insurance company that you have selected classifies the inlays and onlays procedure in the major category as they do for full coverage crowns, then it is possible that you will be compensated at the 50 percent coverage rate.

Again as this is variable, it is best that you verify with the insurance company that you have selected. In event you wish to be really sure how much compensation you will receive, you could ask your dentist for an estimate of the cost, and submitting this to the company, you can ask at what rate you will be compensated. That way you will have a clear idea of the cost and reimbursement that you will have to prepare for.

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Orthodontic Braces (Dental braces or simply braces) commonly employed to straighten crooked or misaligned teeth come under a branch of dentistry known as Orthodontics.

Braces are employed in many cases of malocclusion such as open bite, deep bite, cross bite and other structural and cosmetic flaws. Braces shape your teeth in the desired form by constantly exerting pressure on the teeth in question. Braces can also used along with other orthodontic appliances for successful treatment of Orthodontic problems

Types of Dental Braces

Different types of Braces are required depending on the requirement of the patient. Orthodontic Braces are generally classified as

Traditional Braces

These are the ones that come to our minds when we think of dental braces. The stainless steel color wire covering the full mouth with metal brackets soldered on to the steel wire. These are now outdated and not preferred by patients generally but still present an economical option for the interested.

Ceramic Braces

Ceramic Braces are not as apparent as the traditional ones and they tend to blend with the color of teeth and hence providing a more appealing alternative. They are susceptible to damage by accidental blows or trauma.

Lingual Braces

These are fitted behind the teeth and hence are not apparent from the outside.

Invisalign

Aesthetic clear braces resembling tooth color are marketed under the trade name Invisalign. They blend in with the teeth making them virtually invisible. Invisalign are a boon for patients who always needed braces but avoided them because of cosmetic reasons. They are removable enabling the wearer to snap them on and off when required.

However, Invisalign treatments tend to take longer, are costly and not preferred in complex orthodontic cases.

How Braces Work?

Braces work by application of constant pressure on the teeth over a period of time. Although the force applied isn’t substantially high, the constant pressure coupled with the time factor manages to reshape the teeth in the desired way.

When pressure is exerted on the teeth, they start moving in the desired direction. This causes the bony socket (which holds and serves as anchor point of teeth) to get remodeled based on the newly acquired position. This is known as bone remodeling which is carried out by selective deposition and resoption of the bone to support the newly acquired position.

Time is an important factor. You can’t apply a great force and expect to align your teeth in a few days as this will rather damage them. There is a limit to the force your teeth can handle. An optimum pressure along with suitable time achieves the best results in orthodontic treatments. The average tooth movement is 1mm per month although there is no standard and different people show different responses to the treatment

Procedure for getting Braces?

You should first consult an Orthodontist (A dentist specializing in Orthodontic Treatments) who will make an oral examination and determine whether you require braces.

Preliminary tests will be conducted such as impression making of your mouth and X rays. The results of these tests are analyzed to determine your exact requirements and a plan of action.

The Orthodontic treatment period can range from 6 months to 3 years or even more depending on the severity of the problem. In extreme cases, Orthognathic surgery might be the best viable option.

The teeth which will receive the brace will undergo a process called etching which creates micro-porosities on the teeth surface. A bonding agent is added which helps strengthen the bond between the teeth and composite. The composite is a material which is added to a single tooth and then a small square like metal piece (called bracket) is attached to it. A special light is then projected on the teeth with the bracket to help in hardening the composite so that it better retains the brackets.

This process is repeated for all the teeth which are to be shaped. Molar bands are metal bands that are placed on your first molar which make sure that the bracket sticks well. A typical archwire is then passed through the brackets and secured with ligatures.

Braces tend to hurt up to a week after getting them and the pain should subside soon enough. You should take regular visits to your dentist (generally at 1 month intervals) after getting your braces. The dentist may tighten, modify or even replace the arch wire depending on your teeth response to the brace.

Retainers

Retainers are worn by the patient after the completion of treatment by the Dental braces. These are used to “retain” the newly acquired position of the teeth so that they don’t revert back to their original positions.

Retainers are essential to orthodontic treatments. Many people tend to give them a miss only to realize later that their teeth have shifted back to their original positions wasting all the time, money and effort they put in over the years.

The dentist will suggest a retainer specific to your needs and you need to make sure you stick to his directions.

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problems

What exactly are inlays and onlays?

Dental Braces