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Posts for: July, 2014

By Michael W Shields DDS
July 21, 2014
Category: Dental Procedures
Tags: fillings  
FrequentlyAskedQuestionsaboutInlaysandOnlays

Q: I’ve never heard these terms used in dentistry. What are they?
A: In the decorative arts, an inlay refers to a small piece of distinctive material that’s set into a larger matrix: a mother of pearl accent worked into the lid of a wooden box, for example. In dentistry, it means something similar: a filling (or restoration) that’s fabricated in a dental laboratory, and then set into a tooth in an area that has been damaged or lost.

Q: What’s the difference between inlays and onlays?
A: An inlay is made to fit in between the cusps (small points or ridges) of a back tooth (molar or premolar), and it covers only a small region of the biting surface of the tooth. If the restoration covers one or more of the cusps, it’s an onlay.

Q: Why would I need to have one of these restorations?
A: When a tooth has suffered damage (from decay or trauma, for example), and the affected area is too large to fill with a simple filling — but not large enough to need a full crown (cap) — then an inlay or onlay may be just right. Both of these procedures are considered “indirect fillings,” because the restoration itself is custom-fabricated in a laboratory and then bonded to the tooth in the dental office.

Q: What is the procedure for getting an inlay or onlay?
A: It’s similar to having a crown placed, in that it typically takes more than one office visit — yet an inlay or onlay involves less removal of tooth structure than a crown would require. On the first visit, after the area has been anesthetized (usually with a numbing shot), any decay is removed, and the tooth is shaped to receive the restoration. Next, a model of the tooth is made (either with putty or in digital form), and the tooth receives a temporary filling. The laboratory uses this model to create the actual inlay or onlay, which may take a few days; it is then permanently attached to the tooth on a second visit to the office. However, with today’s advances in CAD/CAM (computer aided design/ manufacturing) technology, some inlays or onlays can be made in the office and placed in the same visit.

Q: What else do I need to know about these tooth restorations?
A: Both inlays and onlays are strong and long-lasting restorations that need no more care than you would normally give your teeth: namely, regular brushing and flossing, and periodic checkups at our office. But because they don’t require the removal of a great deal of natural tooth material, they are considered relatively conservative treatments. After a thorough dental examination, we can recommend the type of tooth restoration that’s most appropriate in your individual circumstances.

If you’d like to find out more about inlays or onlays, please contact us or schedule an appointment for a consultation. You can also read the Dear Doctor magazine articles “Porcelain Crowns & Veneers” and “The Natural Beauty of Tooth Colored Fillings.”


By Michael W Shields DDS
July 11, 2014
Category: Dental Procedures
KellyClarksonGetstotheRootoftheProblem

Now that celebrities can communicate directly with their fans through social media, we’ve started to see dispatches from some surprising locations — the dental chair, for example! Take singer Kelly Clarkson, who was the first winner of American Idol, and perhaps one of the first to seek moral support via social media before having an emergency root canal procedure.

“Emergency root canal — I’ve had better days,” Kelly posted on her Facebook page, along with a photo of herself looking… well, pretty nervous. But is a root canal procedure really something to be scared about? It’s time to clear up some misconceptions about this very common dental procedure.

First of all, root canal treatment is done to save a tooth that might otherwise be lost to an infection deep inside it. So while it’s often looked upon with apprehension, it’s a very positive step to take if you want to keep your teeth as long as possible. Secondly, tooth infections can be painful — but it’s the root canal procedure that stops the pain. What, actually, is done during this tooth-saving treatment?

First, a local anesthetic is administered to keep you from feeling any pain. Then, a small opening is made through the chewing surface of the infected tooth, giving access to the central space inside, which is called the “pulp chamber.” A set of tiny instruments is used to remove the diseased pulp (nerve) tissue in the chamber, and to clean out the root canals: branching tunnel-like spaces that run from the pulp chamber through the root (or roots) of the tooth. The cleared canals are then filled and sealed.

At a later appointment, we will give you a more permanent filling or, more likely, a crown, to restore your tooth’s full function and protect it from further injury. A tooth that has had a root canal followed by a proper restoration can last as long as any other natural tooth — a very long time indeed.

If you have any questions about root canal treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “A Step by Step Guide to Root Canal Treatment.”