Find out why we believe in a Modern way to restore damaged teeth
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Where possible, we restore damaged teeth with Composite fillings. However, the Composite we use in the surgery for filling teeth is not as hard-wearing or resilient as real tooth structure.
This doesn't matter much if the repair is not particularly large or subjected to a lot of chewing stresses, but where a tooth is more severely damaged, the filling won't last and will break or crumble.
Inlays and Onlays are essentially fillings that are made in a lab from a much stronger material so that they last for years.
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Crowns are when the entire tooth is shaved down to a stump, and a shell is made from one of various materials to cover it.
This used to be necessary when bonding technology wasn't so good, and we needed the shape of the shaved tooth to be naturally retentive in order to hold the crown in place. But that's no longer the case with modern materials and techniques.
The main reasons we're not fans of crowns are:
They involve quite a lot of damage to healthy tooth structure
The damage involved undermines the structural integrity of the remaining tooth, often leading to it eventually breaking
The trauma of the tooth preparation can cause the nerves in previously healthy teeth to die and need root canal treatment
Typically, any bits of old fillings (including mercury fillings) left in the tooth are kept and form part of the stump
They're hard to monitor over time, as we can't see underneath them with visual inspection or x-rays; only around them.
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They're more technically demanding and time-consuming to get right. Crowns are more forgiving in the short term, as they're less likely to fall out due to the retentive shape caused by the aggressive tooth preparation.
If a dentist isn't good with bonding, Inlays and Onlays will fail.
When we prepare teeth for Inlays and Onlays, we only remove old filling material and any tooth structure that's already damaged or decayed. We keep everything healthy.
Nature did a pretty good job designing your teeth, so the more of them we keep, the better.
Because we don't do anything aggressive to the teeth, nerves that were healthy before we started tend to stay that way.
Inlays and Onlays, when done well, blend beautifully with the surrounding tooth structure, so they effectively disappear.
They're colour matched and made from materials that behave like teeth over time, so they also age beautifully.
A step-by-step guide to these Modern alternatives to crowns
When we assess the tooth at examination (or sometimes in an emergency appointment, if the tooth has recently broken), we will check the health of the tooth and the nerve and its suitability for an Inlay or Onlay.
We'll often discuss the alternative of a direct Composite filling instead and the potential short-term and long-term advantages of each option.
We'll check everything and discuss all your options with you in detail.
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