The porcelain Inlay: Less invasive than a crown

Q: My doctor told me: “you should really have a crown.” (And I thought since I am head of the household in my family, why shouldn’t I wear a crown at home!)

I don’t like the idea of having my tooth drilled down to a stump. Are there any alternatives?

A: Alas! The porcelain inlay is your new best friend!

When a tooth has decay or fracture around an old filling or when an existing crown has decay underneath or had had a root canal, it is necessary to drill away enough tooth structure to allow a cap (crown) to cover the entire tooth. Otherwise, you risk having the tooth fracture below the gum line warranting an extraction and dental implant.

If you have enough healthy tooth structure after the old filling and all the decay has been removed, we an take a digital impression the remaining tooth structure and have the lab mill or cast an inlay out of porcelain. This will preserve the healthy parts of your tooth.

Inlays are much better than composite fillings (bonding). Many doctors, including myself, avoid placing white fillings in deep cavities on posterior teeth. Many patients have terrible sensitivity on these teeth post operatively and require root canal treatment. They also may only last less than five years. Inlays can last for decades as they are more amenable to cleaning with flossing and brushing as they are rarely placed below the gum line.

Don’t worry, you will still be head of your household without a crown!