Inlays and onlays are precision restorations designed to repair and reinforce back teeth while preserving as much healthy structure as possible. Unlike a full crown, which caps the entire tooth, these restorations replace only the damaged or decayed portion—an inlay fits inside the tooth’s cusps, while an onlay extends over one or more cusps to rebuild and protect chewing surfaces. Their conservative nature makes them an attractive option when a direct filling would be insufficient but a crown is unnecessarily invasive.
Because these restorations are fabricated outside the mouth and bonded into place, they offer tight margins and predictable anatomy that are difficult to achieve with direct fillings. That accuracy preserves neighboring tooth contacts and helps maintain proper bite relationships. Patients often appreciate that an inlay or onlay restores function and appearance without the more extensive preparation required for full-coverage restorations.
From a functional standpoint, a well-made inlay or onlay redistributes biting forces across a larger area of remaining tooth structure, reducing the risk of fracture. When bonded correctly, these indirect restorations can serve as a durable repair that supports chewing efficiency while blending with adjacent teeth for a natural look.
Our clinical goal is to balance conservation and strength. At Briter Dental we evaluate each tooth on its own merits—prioritizing options that maintain vitality, restore form, and prolong the tooth’s healthy lifespan whenever possible.
Several clinical factors influence whether an inlay or onlay is the best choice. The amount of remaining tooth structure is paramount: when a large portion of the cusp or the occlusal surface is missing but the root and surrounding walls are intact, an onlay can rebuild and protect the weakened areas. Conversely, an inlay is often appropriate when the damage is confined to the grooves and pits without cusp involvement.
Bite dynamics and parafunctional habits also play a role. High bite forces or bruxism change how restorations are loaded and may require materials with enhanced strength or additional protective measures, such as a nightguard. The location of the tooth in the mouth matters too—posterior teeth that endure heavy chewing may benefit from the durability of an indirect restoration more than smaller anterior teeth.
Cosmetic expectations and material preferences are part of the decision process as well. Many patients want a tooth-colored solution that resists discoloration and mirrors the translucency of enamel, which ceramic or porcelain inlays/onlays can deliver. During a diagnostic appointment your dentist will review radiographs, evaluate remaining structure, and discuss how an inlay or onlay fits into your overall restorative plan.
Importantly, these restorations are also a common choice for replacing large or leaking fillings. When an old filling fails or introduces microleakage, a precisely fabricated inlay or onlay can restore a tight seal and reduce the chance of recurrent decay at the margins.
Treatment typically begins with removal of decay or old restorative material and careful shaping of the preparation to receive the new piece. The goal is to create a stable, clean surface that allows the restoration to seat fully and bond securely. Digital scans or traditional impressions are then taken to capture the exact contours of the prepared tooth and the bite with adjacent teeth.
Depending on the practice’s workflow, the restoration may be produced in a dental laboratory or milled in-office with CAD/CAM technology. Both approaches produce precise results; laboratory-fabricated pieces benefit from specialized technicians, while same-day milling offers the convenience of completing treatment in a single visit. Your clinician will explain which option is being used and how it affects the timeline.
At the placement visit the dentist will verify fit, contacts, and color match before permanently bonding the restoration. Proper bonding technique is essential to reinforce the tooth and create a seamless junction between restoration and natural enamel. After cementation, the bite is checked and minor adjustments are made so the occlusion feels even and comfortable.
Ceramic and porcelain are common choices because they combine strength with an appearance that closely mimics natural enamel. These materials can be shaded, glazed, and polished for a lifelike finish and are highly resistant to staining. Newer high-strength ceramics have also improved durability, making them well-suited to posterior restorations that face significant masticatory forces.
Metal or gold inlays and onlays remain an option in some cases, particularly where ultimate longevity and wear resistance are prioritized over aesthetic concerns. Each material has trade-offs: metal offers exceptional strength but is visible, while ceramics provide a natural look with very good strength when bonded properly. Your dentist will discuss material recommendations based on the tooth’s position, your bite, and aesthetic goals.
Longevity depends on several factors beyond material choice, including the quality of the fit, the success of the bond, and how the tooth is cared for afterward. With appropriate maintenance and regular dental oversight, inlays and onlays commonly last many years and can be a more predictable long-term solution than large direct fillings.
When planning treatment, clinicians weigh durability against conservation and appearance, aiming to select a material and restoration design that meet each patient’s functional needs and cosmetic expectations.
Once in place, inlays and onlays require the same basic oral hygiene practices as natural teeth. Brushing twice daily with fluoride toothpaste and daily flossing help minimize plaque buildup at the restoration margins, where recurrent decay can begin. Routine professional cleanings and exams allow your dental team to monitor the restoration, catch early signs of wear, and address any seal or margin concerns promptly.
Avoiding extreme chewing habits—such as biting hard candies, ice, or other very hard objects—protects the restoration from unnecessary stress. If you grind your teeth at night, using a custom nightguard can dramatically reduce wear and extend the life of the restoration. Report any new sensitivity, roughness at the margin, or changes in your bite so the restoration can be evaluated without delay.
Over time restorations may need maintenance: small adjustments, polishings, or in rare cases, replacement. Regular x-rays and clinical exams give the dental team the information needed to make those decisions proactively, helping the restored tooth remain functional and comfortable for years.
Inlays and onlays are an effective, conservative way to repair posterior teeth while preserving natural structure and restoring reliable function. If you’re wondering whether this type of restoration suits your needs, our team can explain the options and next steps. Contact Briter Dental to learn more or to schedule an evaluation with one of our clinicians who can recommend the best path forward for protecting and restoring your smile.
Inlays and onlays are precision-made restorations used to repair back teeth that have decay or structural damage but do not require a full crown. An inlay fits within the cusps and grooves of a posterior tooth, while an onlay extends over one or more cusps to rebuild and protect weakened areas. Both are fabricated to match the tooth’s contours and are bonded in place to restore function and form.
Because they are crafted outside the mouth, these restorations can achieve very smooth margins and accurate contacts with neighboring teeth. The conservative nature of inlays and onlays preserves healthy enamel and dentin, which supports long-term tooth vitality. Patients often choose them when they want a durable, tooth-colored alternative to large direct fillings or more invasive full-coverage restorations.
Direct fillings are placed and shaped inside the mouth and are best for small cavities, while inlays and onlays are lab- or mill-fabricated and offer superior anatomical detail and wear resistance. Compared with crowns, inlays and onlays require less removal of healthy tooth structure because they only replace the damaged portion of the tooth. This conservative approach helps maintain tooth strength and can reduce the long-term risk of needing root canal therapy.
In practice, the choice among a filling, an inlay/onlay, or a crown depends on the extent of damage, occlusal forces, and esthetic needs. Inlays and onlays often provide better margins and contacts than large direct restorations and can be a durable compromise when a crown would be unnecessarily aggressive. Your dentist will weigh functional and esthetic outcomes when recommending the optimal option.
Common materials for inlays and onlays include high-strength ceramics or porcelain, composite resin, and metal alloys such as gold. Ceramic and porcelain are favored for posterior teeth when tooth-colored esthetics and stain resistance are important, while gold remains an excellent choice when maximum strength and longevity are priorities. Composite resin can be used in select situations for a more conservative or cost-effective tooth-colored option.
The ideal material depends on the restoration’s location, the patient’s bite, and esthetic goals; ceramics excel at matching natural translucency, whereas metals perform well under heavy occlusal load. Your clinician will recommend a material that balances durability, appearance, and functional demands for each specific tooth. Advances in ceramic technology have improved fracture resistance and wear compatibility with opposing teeth.
Good candidates are patients with moderate decay or fractures that affect a significant portion of a posterior tooth but do not justify full-crown coverage because sufficient tooth structure remains. Inlays and onlays are also appropriate for replacing large failing fillings that have begun to leak or fracture, or when a tooth requires cusp protection without removing healthy enamel. Patients with good oral hygiene and controlled gum disease generally experience the best long-term outcomes.
Patient-specific factors such as bite patterns, bruxism, cavity size, and overall restorative plans influence candidacy for these restorations. Heavy grinders may need occlusal adjustments or a nightguard to protect any indirect restoration, and compromised teeth with extensive structural loss may be better served with crowns. A clinical exam and diagnostic imaging will determine whether an inlay or onlay is the most conservative, durable choice.
Treatment usually begins with removing decay and old restorative material, followed by shaping the tooth to receive the custom restoration and taking an impression or digital scan. If a lab is used, a temporary restoration may be placed while the inlay or onlay is fabricated; if an in-office CAD/CAM system is available, the restoration can sometimes be milled and placed the same day. At the placement visit the dentist will check fit, contacts, and shade, then bond the restoration using a strong resin cement and make final occlusal adjustments.
Local anesthesia is typically used so the procedure is comfortable, and most patients experience only minimal postoperative sensitivity after bonding is complete. Proper bonding reinforces the remaining tooth structure and helps distribute biting forces evenly across the restoration. At Briter Dental we prioritize precise fit and gentle placement to minimize sensitivity and maximize long-term performance.
Yes, many practices offer single-visit solutions using CAD/CAM technology that allows digital scanning, in-office milling, and same-day placement of ceramic restorations. This approach eliminates the need for a temporary restoration and reduces the number of appointments while still delivering a well-fitting, esthetic result. Not all offices use in-office milling, however, and some clinicians prefer laboratory fabrication for complex cases or specific material choices.
Laboratory-made inlays and onlays remain a highly reliable option and may provide additional customization such as layered ceramics or specialized occlusal adjustments. Whether single-visit or lab-fabricated, the goal is the same: a precise, durable restoration tailored to the tooth’s anatomy and the patient’s bite. Your dentist will discuss the best workflow based on clinical needs and available technology.
With proper care and regular dental monitoring, inlays and onlays commonly last a decade or more, and many function successfully for several decades depending on the material and oral environment. Ceramic and gold restorations are known for long-term durability, while composite options may wear faster but can be more easily repaired. The restoration’s location, the patient’s bite forces, and parafunctional habits such as grinding all influence longevity.
Routine dental examinations allow your clinician to check margins, contacts, and occlusion so any issues can be addressed early before failure occurs. Prompt attention to minor defects can often extend the life of a restoration, and maintaining excellent oral hygiene reduces the risk of recurrent decay at the margins. Discuss expected longevity for your specific case with your dentist to set realistic expectations and plan appropriate follow-up care.
Maintaining the restoration begins with excellent daily oral hygiene: brush twice with fluoride toothpaste and floss daily to minimize plaque buildup at the margins. Avoid repeatedly chewing excessively hard or sticky items that can stress the restoration, and do not use your teeth as tools to open packages. If you have a history of clenching or grinding, wearing a custom nightguard can protect indirect restorations from premature wear or fracture.
Keep up with regular dental checkups and professional cleanings so your dentist can monitor the restoration and the supporting tooth structure. Early detection of wear, marginal breakdown, or recurring decay enables conservative repairs rather than full replacement in many cases. By combining good home care with routine professional oversight, you help ensure the restoration performs well for years.
Be alert for changes such as new or persistent sensitivity, a rough or catching feeling at the restoration’s edge, visible gaps or discoloration at the margins, or a change in how your bite feels. These symptoms can indicate microleakage, marginal breakdown, fracture, or wear that requires evaluation. If you notice any of these signs, schedule an examination so the restoration can be assessed clinically and radiographically.
Your dentist may be able to repair minor defects, rebond a dislodged piece, or recommend full replacement depending on the extent of damage and the condition of the underlying tooth. Timely intervention often prevents more extensive treatment and helps preserve natural tooth structure. Regular monitoring during recall visits also helps catch issues before they become symptomatic.
Decision-making begins with a comprehensive clinical exam and diagnostic imaging to evaluate the extent of decay or fracture, the amount of remaining tooth structure, and occlusal forces. The dentist will consider functional needs, esthetic goals, and the overall restorative plan for adjacent teeth to determine whether a conservative indirect restoration is appropriate. When multiple options exist, the clinician will explain the benefits and limitations of each approach and how they relate to the tooth’s long-term prognosis.
Patient preferences and oral health factors—such as bruxism, periodontal status, and hygiene—also influence the recommendation, and the chosen treatment aims to balance durability with tooth conservation. We take a conservative, evidence-based approach to restorative care and tailor recommendations to each patient’s circumstances. If an inlay or onlay is recommended, the plan will include details about the material choice, expected steps, and follow-up to ensure predictable results.