When people think of repairing teeth, fillings usually come to mind first. But there are also other types of restorations, such as crowns. The two main ways of making a restoration are called direct and indirect restorations.

From the American Dental Association (ADA):

Direct Restorations

Fillings are used to repair a tooth damaged by decay. With direct restorations, the dentist puts the filling material right into the tooth. When you get a filling, the dentist first removes the decayed part of the tooth. Then the dentist cleans the area and fills the cavity. Most of the time, this happens during a single visit.

After some dental fillings are placed, patients may be sensitive to hot or cold for a short time. In rare cases, patients may have an allergic reaction in that area to some ingredients in dental filling materials. It is important to talk to your dentist if you are concerned.

Indirect Restorations

Instead of being made directly in the tooth, indirect restorations are made in a lab and then placed on the tooth. Indirect restorations include crowns, inlays and onlays.

Typically, indirect restorations require two or more visits to place. During the first visit, the dentist prepares the tooth and makes an impression of the area to be restored. The impression is sent to a dental lab. The lab then makes the dental restoration. At the next appointment, the dentist cements the restoration into the prepared cavity and adjusts it as needed.

The cost of indirect restorations is generally higher due to the number and length of visits required, and the extra cost of having the restoration made in a dental lab. As with direct restorations, talk to your dentist about possible allergic reactions to certain dental materials.

Crowns

A crown is an indirect restoration that covers or “caps” a tooth to restore it to its normal size, shape and function. It covers the entire chewing surface and sides of the tooth. It usually requires two dental visits to complete a crown.

During the first visit, the dentist prepares the tooth by removing the outer portion so the crown can fit over it. If additional tooth structure is needed to support the crown, the dentist may build up the core of the tooth.

An impression is made to provide an exact model of the prepared tooth. Your dentist or a lab technician then uses the model to develop the shape and size of the crown.

A temporary cap is placed on the tooth until the final crown is made. When the crown is ready, your dentist places it and adjusts it for your comfort. When you and your dentist like how the crown looks and feels, your dentist will cement the crown into place.

Inlays and Onlays

An inlay is a special kind of filling that may be used to repair the chewing surfaces of a back tooth like a molar, premolar or bicuspid. It fits into the contours of the tooth, between the cusps (points) of the biting surface. The inlay restores the space that remains after the dentist removes the decay or old filling.

An onlay is like an inlay, but it is bigger and covers some or all chewing surfaces of the tooth. It may provide more coverage for a tooth that has lost much of its biting surface when decay damages the surface between teeth. Your dentist may recommend an onlay based on how damaged the tooth is.

During the first visit, the dentist prepares the tooth by removing the old filling or decay. The tooth is then shaped for the restoration. Next, the dentist makes an impression of the tooth, the opposing teeth and the bite. The dentist then makes a model. From that model, the inlay or onlay is made in a dental lab. A temporary filling protects the tooth until the next visit, when it is removed.

During the second visit, the permanent inlay or onlay is checked for fit before the dentist cements it to the tooth. The dentist then adjusts the inlay

If you have any questions about tooth restoration, click here to contact Dr. Barrow.