We usually use anesthesia first. The space is shaped deeper and wider than for composite resin, so it would feel sensitive without it. Once you are numb, you will feel the drilling but no pain.

How many visits does it take?

Two. On the first day we shape the space and take an impression. The piece is made in a lab, so it is bonded on the second day.

What should I do in between?

We cover the space with a temporary material. You can eat as usual, but it is best to avoid very tough or sticky foods on that side. The temporary material is attached so it can be removed later, so if it comes off, do not leave it — please contact us.

Can’t composite resin do the job?

It depends on the size of the cavity. When the area is large, a filling placed directly cannot stand up to chewing forces and starts to come apart at the edges. At that size, we use an inlay. Not because it is a better treatment, but because it is the treatment that fits that size.

How long does it last?

It depends on how you care for it. The piece itself does not wear down easily, but if a new cavity forms at the bonded edge, it has to be removed and the tooth treated again.

Cavities

InlayBack-tooth inlay · Cavity inlay

Side by side: a piece with a chip broken off, and a piece smooth again after the gap was filled.

Same day: 2 visits
Time: 20 minutes
Anesthesia: Yes
Visit interval: 1 week
Lifespan: 3–5 years
Cost: Explained after your exam

An inlay is a treatment where we take an impression of the space left after removing decay and make a separate piece that fits it exactly, then fit it in. Instead of filling the space directly, a piece made outside the mouth from the impression is bonded in place.

Because it is made outside the mouth, the shape of the chewing surface can be made precisely, and it holds up well even over a wide area. It does take two visits, and more tooth is removed than with composite resin.

We use an inlay when decay has spread wide to the sides and a filling placed directly would not stand up to chewing forces. You can see where that point is in the stage chart below.

A piece that fits exactly is about to settle into a square hollow carved in stone.

Why an inlay

Precise biteIt is made outside the mouth from an impression. Compared with shaping it directly in the mouth, the contours of the chewing surface and the contact with the neighboring tooth can be made more precisely.

Holds up over a wide areaIt is a single solid piece, so chewing force spreads evenly. It holds up at a size where a filling placed directly would start to come apart at the edges.

Lasts longerThe material does not wear down or change color easily. It depends on care, but it is considered to last longer than a filling.

How an inlay is done

It takes two visits. On the first day we shape the space and take an impression, and on the second day we bond the finished piece.

01
We check how far the decay goes
Decay is wider inside than the hole you see on the surface. How far it has spread sideways decides whether we fill it with composite resin or treat it with an inlay.
02
We shape the space with straight walls
After removing the decay, we shape the edges straight. For a solid piece to fit in, the opening has to be wider than the inside, so more tooth is removed than with composite resin.
03
We take an impression and cover it temporarily
We take an impression of the shaped space and send it to the lab. In the meantime, it is covered with a temporary material, so you do not have to go around with an open hole.
04
We bond the finished piece
On your second visit, we remove the temporary material and bond the piece, made as a single solid unit, in place. Once the height is adjusted, treatment is done.

What each stage of a cavity needs

Two cavities can need different treatment depending on how far each has gone. We decide by how much of the inside of the tooth has broken down, not by the size of the hole you can see.

Stage 1 · A small cavity

The decay is still in the outer layer (enamel), or has only just reached the layer below. The outer layer has no nerves, so it does not hurt, and few people notice a cavity at this stage. The walls around it are intact, so we remove only the decayed part and fill it right away. This is the stage where the least tooth is removed.

Composite filling

Stage 2 · A large cavity

The layer under the enamel is much softer, so the decay spreads sideways. The opening stays narrow while the inside widens, and cold things start to sting. Once it is this wide, a filling placed directly in the mouth cannot hold up to chewing and starts to separate at the edges. So we take an impression and make a piece that fits exactly, then set it in place.

Inlay

Stage 3 · A cavity with a broken wall

One of the cusps on the chewing surface has broken off entirely, and there is no wall left to fill against. This is the stage where a tooth cracks while you are chewing. Whatever we fill it with, the force lands on one side, and the same spot breaks again. We shape what is left and cover the whole tooth so it takes force evenly.

Zirconia crown

Stage 4 · A cavity that has reached the nerve

It throbs even when you are doing nothing, and it gets worse at night. The nerve is sealed inside the hard tooth, so when it swells the pressure has nowhere to go, and the pain is severe. First the nerve inside the tooth has to be treated. A tooth that has been hollowed out breaks easily, so it is covered afterward. This is the only stage that needs two treatments.

Root canal treatment, then a zirconia crown

Does it hurt?
We usually use anesthesia first. The space is shaped deeper and wider than for composite resin, so it would feel sensitive without it. Once you are numb, you will feel the drilling but no pain.
How many visits does it take?
Two. On the first day we shape the space and take an impression. The piece is made in a lab, so it is bonded on the second day.
What should I do in between?
We cover the space with a temporary material. You can eat as usual, but it is best to avoid very tough or sticky foods on that side. The temporary material is attached so it can be removed later, so if it comes off, do not leave it — please contact us.
Can’t composite resin do the job?
It depends on the size of the cavity. When the area is large, a filling placed directly cannot stand up to chewing forces and starts to come apart at the edges. At that size, we use an inlay. Not because it is a better treatment, but because it is the treatment that fits that size.
How long does it last?
It depends on how you care for it. The piece itself does not wear down easily, but if a new cavity forms at the bonded edge, it has to be removed and the tooth treated again.