Family & Cosmetic Dentistry in Washington DC

Inlays & Onlays

inlaysWhen more than half of a tooth is damaged, Dr. Grogan may advise replacing the damaged structure with an inlay or onlay. Many times, these are conservative alternatives to crowns and fillings. If the damage is minimal, inlays are appropriate. When the damage is more extensive (but not enough to warrant replacement with a crown) onlays may be best. Inlays and onlays are made from porcelain, gold or composite resins that are bonded directly to the teeth. These materials are much stronger than traditional blended-metal fillings and can help prevent further decay or damage.

Procedure

First, the damaged areas (or old fillings) are removed.  We use a special device that can detect all signs of decay. In this way, we can be sure we’re removing all of the decay while saving as much of the good tooth as possible. An impression is then taken and sent to a dental lab where the restoration is constructed.

After the inlay or onlay is completed, we will check for proper fit, then bond the well-fitted restoration to your tooth with a strong resin.

Minimally Invasive Dentistry

The phrase minimally invasive dentistry refers to new materials that enable us to minimize the amount of tooth drilled when placing a filling. These materials allow us to keep a greater percentage of healthy tooth, remove decay more quickly, match tooth color, and reduce the likelihood of tooth fracture.

Previously, we were limited to the use of silver amalgam due to the lack of conservative alternatives. It was far from an ideal option for small amounts of decay. With silver amalgam, the tooth needed to be drilled at least 1.5 mm deep and 1 mm wide to prevent fractures in the material from chewing forces, regardless of how small the decay was. As a result, many dentists would “watch” decay progress, because they couldn’t justify drilling so deeply into healthy tooth with a tiny bit of decay. Of course, over time, the decay would grow and the dentist would then feel better about drilling a larger hole to fill with silver amalgam.

Fortunately, we now have much better composite restoration material. These new composites allow us to bond to the tooth and drill very minimally to remove small amounts of decay. The key is to spot the decay early, clean it completely, and bond and seal the composite restoration to the tooth. That is why many of us use magnification loupes, microscopes and other high tech instruments, such as lasers, that find decay in its early stages.

Silver amalgam has not been used in our office for many years for obvious reasons. It should be noted that there might be instances where it would work well, such as on the biting surface of a gold crown that has worn through. In most cases, however, we prefer to use composites for their benefits to the health and appearance of our patient’s teeth