Inlay instead of Dental Filling

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Inlay instead of Dental Filling

Tooth ache is always so extremely annoying – especially when the actual damage to the hurting tooth is more severe than originally anticipated. Not too long ago, a good family friend of ours was in a situation just like this one. Completely unexpectedly he was hit by toothache and during a check-up visit with his dentist he received a clear diagnosis: caries had caused significant decay to the surface and side areas of one of his molars on the lower left side of his jaw. Though the total extent of the damage was not quite severe enough to warrant a root canal procedure, it was still so large that a simple tooth filling could not fix it. Therefore, the dentist recommended a dental inlay as the best treatment option. 

Dentist with microscope prior to inlay procedure

I had personally not even heard about inlays at that point in my life and so our buddy had to give us an introductory “crash course” on what inlays are and why they are beneficial.

What is an inlay?

An inlay is a form of tooth filling that dentists use to treat those cases of tooth decay that are too severe for mere dental fillings, yet not quite severe enough for root canals and dental crowns. Generally, dentists recommend the use of inlays whenever a tooth is damaged by caries to a degree that cannot reliably be repaired via a conventional tooth filling. Additionally, inlays are among the best and most reliable treatment options for damage on the side of a tooth.

To successfully place an inlay, a dentist has to first carefully remove the decayed part of a tooth and, if applicable, the broken filling. Afterwards, the medical professional takes an imprint of the cleaned-out cavity and sends it to a dental lab for the manufacture of a custom-made inlay. A modern alternative to this approach is the so-called Cerec method which involves a dentist thoroughly filming a decaying tooth with a special camera and then using the digital images to design a tailor-made inlay on a computer. As a next step, the dentist shapes the inlay out of a porcelain-block right there in his practice without having to rely on a dental lab. The final step of the inlay placement process is attaching the inlay onto the treated tooth itself (depending on the material used for the inlay, it is either cemented or glued to the tooth).

Nowadays, dentists and patients can choose from a wide variety of inlay types that are each made from different materials:

Gold Inlay – Even nowadays, many dentists put their trust into gold as the best material for inlays. The perhaps greatest advantages of gold are its longevity and durability (roughly 20 to 30 years) and its tolerability. Also, gold is highly resistant to even the strongest chewing pressure and is a very good option for repairing damage located on the side of a tooth. The most prominent drawbacks of gold inlays are the fact that they are easily noticeable (due to their visible color) and that they increase a treated tooth’s sensitivity to temperature changes.   

Ceramic Inlay – This type of inlay is used fairly frequently due to its solid longevity and durability for up to 15 years. The two most prominent advantages of these inlays are their inconspicuous color, which can blend in seamlessly with surrounding teeth, and their ability to significantly reduce a treated tooth’s sensitivity to temperature changes. A few important drawbacks of ceramic inlays are their lower resistance to pressure (compared to gold inlays) and the fact that fissures between the inlay and the tooth edge may form over time and compromise the structure of the treated tooth. On top of that, a ceramic inlay is harder than the dental enamel of adjacent teeth and may therefore potentially lead to damages to other healthy teeth.

Composite Inlay – This inlay version is more cost-efficient than those made of gold or ceramic but also has a more limited use potential that is restricted to smaller cavities. Though a composite inlay can blend in with the color of adjacent teeth seamlessly, its white color may wear off over time. Additionally, this inlay type has the lowest longevity and durability (estimated at 4-6 years).

Galvano Inlay – A galvano inlay is made of a mixture between gold and ceramic material. The most prominent advantages of this inlay type are its solid longevity and durability (10-15 years) and the fact that it rarely allows for the formation of fissures between the inlay itself and the edges of the tooth to which it is attached. Conversely, the main drawbacks of a galvano inlay are its increased potential to crack under pressure and its visible golden edge right above the gum line.

Dentist and patient review a panorama x-ray prior to an inlay procedure

After learning of this broad selection of inlay options, our friend opted for a trusted gold inlay given its superior longevity and durability and the fact that the treated molar was not visible to the naked eye.

How much does an inlay cost?

The costs of an inlay can vary from patient to patient and depend heavily on the size, material, and location of the inlay and the treated tooth. Nevertheless, the following pricing guidelines can provide a solid cost estimates to interested patients:
  • Gold Inlay: EUR 250 - 500
  • Ceramic Inlay: EUR 300 - 700
  • Composite Inlay: EUR 40 – 160
  • Galvano Inlay: EUR 300 - 700

In general, governmental insurers do not cover inlays and, at most, pay limited reimbursement amounts similar to those for simple amalgam tooth fillings. For patients with private insurance the exact amounts of their out-of-pocket costs (if they have to cover any) depend on the specific terms outlined in their individual insurance contracts.

Unfortunately, our family friend did not qualify for even a small reimbursement from his dental insurer and had to pay for the whole procedure out of his own pocket. Nevertheless, from a longer-term perspective, the EUR 500 for the treatment were definitely worth it for him because he has not felt any discomfort over the few years that have passed since his inlay placement.

So all’s well that ends well.

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