Family Dentistry of Ocean City
Robert W. Yaskin, D.M.D. LLC
421 15th Street
Ocean City, NJ 08226
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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.”
It takes a lot of skill, experience, talent and artistry to create tooth restorations that look so natural that no one can tell them apart from the originals. To do so requires understanding of the normal anatomy of a tooth as well as of the interactions of light and color.
The color that we perceive when looking at a tooth results from the combined appearance of the tooth’s center core (dentin layer) and its covering enamel. Going from the outside in, the enamel is made of tightly packed crystals of calcium, which cause it to be one of the hardest substances naturally produced by animals. The crystals are also responsible for a tooth’s brilliance and translucence. The dentin is more like bone, a porous living tissue composed of microscopic tubes, interspersed with more calcium crystals. In the very center of the tooth is a central chamber containing the pulp and nerves.
Each of these layers has its own physical and optical properties. Since the enamel is translucent and the dentin is more opaque, most of the tooth’s color comes from the dentin and is transmitted through the enamel layer. Factors that affect this transmission include the thickness and age of the enamel as well as external tooth whitening.
If the enamel is more translucent, more of the color of the dentin shows through. If it is more opaque, the enamel absorbs and reflects light so that less color is visible and the enamel looks brighter.
Color means the whole spectrum in the rainbow. The spectrum is made up of the three primary colors — red, blue, and green. When all are combined, they create white light.
Hue refers to the brightest forms of the colors. The color we perceive depends on the dominant wavelength of light that is reflected by an object.
Value refers to a color’s lightness or darkness. A brighter color has a higher value.
Chroma is the amount of identifiable hue in a color. An achromatic color (without hue) appears gray.
Saturation is a measure of a color’s intensity.
This terminology of color is used not only by dentists and dental technicians, but also by a wide range of artists. It implies expertise and understanding of how colors work, how they vary and change and affect one another.
Contact us today to schedule an appointment or to discuss your questions about bonding to repair chipped teeth. You can also learn more by reading the Dear Doctor article, “Artistic Repair of Front Teeth with Composite Resin.”
While the goal of restorative dentistry is to return all of the destroyed or lost dental tissues of the teeth to full form (shape) and function, when you blend this goal with the artistry of cosmetic dentistry, the results can be dazzling. Today's modern techniques and materials enable replacement of missing tooth structure that allows bonding directly to the tooth so that it not only is an exact color match but also actually strengthens the tooth. And tooth-colored fillings are not just for front teeth. They can dramatically improve the appearance of all teeth — even your back molars — so that it appears you've never had tooth decay at all!
All of this is accomplished through the use of either tooth-colored dental porcelain or composite resins. Porcelains are a form of ceramic material formed by the action of heat. They are available in many colors and shades made from a powder corresponding to the primary color of the natural tooth structure that is mixed with water and placed into an oven for firing (hence their ceramic nature). When built up in layers by highly trained dental ceramicists, they can be made to mimic the exact natural translucency, staining and contours of tooth enamel.
Dental composite resins are the most common materials used for tooth-colored adhesive restorations today and have properties similar to tooth structure. They consist of resin or special plastics and fillers that are made of silica, a form of glass. The fillers give the composites wear resistance and translucency (see through properties).
It is important to note that besides providing the appearance of beautiful teeth, properly restored teeth function and wear better. But most important to you, they appear indistinguishable from natural teeth! Furthermore, scientific studies and clinical experience have validated their use as both safe and predictable. In fact, these techniques are also suitable for children's teeth and can incorporate fluoride to reduce decay. Together, all of these changes have so significantly impacted the way modern dentistry is practiced that many believe we may have entered into the so-called “post-amalgam (silver metal-colored dental fillings) era.”
Contact us today to schedule an appointment to discuss your questions about tooth-colored fillings. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.”
When you say “ahhhhh,” are you worried about all your unsightly metal fillings? If so, did you know that your dentist can resolve your concerns through the use of tooth-colored fillings?
The public's demand for aesthetic tooth-colored (metal free) restorations (fillings) together with the dental profession's desire to preserve as much natural tooth structure as possible has led to the development of special adhesive tooth-colored restorations. And the demand is not limited to just the front teeth. In fact, many people are opting to replace all of their metal fillings — not just those in the front teeth — so that all of their teeth appear younger, fresher and as if they have never had any cavities.
Can you really mimic natural teeth? Proper tooth restoration is a lot more than just filling holes. It is a unique art applied with scientific understanding. Each tooth's internal shape and structure is the guide to how it must be rebuilt to successfully restore it. However, choosing which material to use to restore or rebuild teeth is a critical one based on scientific understanding, experience and clinical judgment — expertise we use daily in our office. The most popular options include composite resins and porcelains, as they allow us to mimic natural tooth colors and shapes. But for the most life-like, natural tooth-colored filling, your best option is porcelain. Porcelain, which is built up in layers, can be made to mimic the natural translucency and contours of tooth enamel.
But what about matching the color? Will it really match? Absolutely! Whether we use resins or porcelain, through our artistry we will create absolute tooth-like replicas. You will never know your teeth have fillings! And unlike metal alloys, these newer materials bond directly to the remaining enamel and dentin of which the teeth themselves are made, thus stabilizing and strengthening them. These techniques are even suitable for children's teeth and can incorporate fluoride to reduce decay.
Still undecided? If so, we understand. Feel free to contact us today to schedule an appointment to discuss your questions about tooth-colored restorations. You can also learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”
The goal of restorative dentistry is to return the teeth to full form (shape) and function. For years, a key tool for achieving this goal has been through the use of metal amalgams (silver looking dental fillings). However, this technique does have some disadvantages. One is the fact that they can involve removal of healthy tooth structure to retain them. Too much “undercutting” can undermine and weaken a tooth resulting in less resistance to biting forces possibly leading to fatigue fractures and cracked tooth syndrome. Another approach is call “biomimetic” which literally means mimicking life. This approach to dentistry is made possible through the structured use of tooth-like materials such as composite resins. Scientific studies and clinical experience have validated their use as both safe and predictable.
By mimicking life, we rely upon our delicate balance of artistry, experience and expertise to provide you with properly restored teeth that function and wear normally, while appearing indistinguishable from natural teeth. Dental composite are now the most commonly used materials for tooth-colored adhesive restorations and have properties similar to a natural tooth's enamel and dentin. They consist of resin which are plastic and fillers made of silica (a form of glass). The fillers give the composites wear resistance and translucency (see through properties). However, most of the properties of enamel are also mimicked quite well by dental porcelains. Porcelains are a form of ceramic, that are formed by the action of heat. Dental porcelains come in all colors and shades so we can easily and perfectly match the color of virtually any natural tooth. As for longevity, porcelain is typically your best option because it is the closest option in mimicking a natural tooth.
To learn more on this subject, you can continue reading the Dear Doctor magazine article “The Natural Beauty of Tooth Colored Fillings.” Or contact us today to schedule an appointment to discuss your specific questions.