Dental inlays are custom-made restorations used to repair moderate damage within the biting surface of a tooth. They may be recommended when a standard dental filling would not provide a predictable repair, but the tooth does not require an onlay or full dental crown.
Inlays are most commonly used on back teeth, including molars and premolars, where restorations must withstand regular chewing pressure.
An inlay fits inside the raised edges of the tooth, known as cusps. It replaces the damaged or decayed area while preserving as much healthy enamel and dentine as possible.
What Are Dental Inlays? The Short Answer
A dental inlay is a custom-made restoration that fits into the biting surface of a damaged back tooth.
Unlike a direct filling, which is placed and shaped inside the mouth, an inlay is usually made from an impression or digital scan. It is then bonded securely into the prepared tooth.
An inlay may be considered when:
- The damaged area is too large for a predictable direct filling
- The tooth’s cusps remain strong and do not require coverage
- An old filling has failed or fractured
- Decay is contained mainly within the biting surface
- The dentist wants to preserve more natural tooth structure than a crown would require
When Are Dental Inlays Used?
A dentist may recommend an inlay where there is moderate decay, a broken or failing filling, or damage that is mainly contained within the central biting surface of the tooth.
Inlays are normally used when the outer walls and cusps of the tooth remain sufficiently strong. If one or more cusps are weakened, an onlay that provides partial cuspal coverage may be more appropriate.
An inlay may be considered where:
- The tooth has a moderate or large cavity
- An existing filling has fractured, leaked or become unsuitable
- The damage is mainly located between the tooth’s cusps
- A direct filling may not provide a sufficiently predictable restoration
- The remaining tooth structure can support a bonded restoration
- A full crown would remove more healthy tooth structure than necessary
The tooth must be assessed carefully before treatment. Extensive decay, severe cracking, weakened cusps or very limited remaining structure may require an onlay, crown or another form of treatment.
What Is the Difference Between an Inlay and an Onlay?
An inlay fits within the biting surface of the tooth and does not normally cover its cusps.
An onlay is larger and extends over one or more weakened cusps. It is sometimes described as a partial-coverage restoration or partial crown.
Both treatments are custom-made outside the mouth and bonded to the prepared tooth. The main difference is how much of the tooth they cover.
Read our related guide explaining how long porcelain onlays may last and the factors that affect their longevity.
Inlay vs Filling vs Onlay vs Crown
The most appropriate restoration depends on the size and location of the damage, the condition of the remaining tooth and the forces placed on it.
A filling is normally used for a small or moderate area that can be restored directly inside the mouth.
An inlay is custom-made and fits within the biting surface without covering the tooth’s cusps.
An onlay covers a larger area and protects one or more weakened cusps.
A crown covers most or all of the visible tooth and may be required where the tooth is extensively damaged, heavily restored or unable to support a partial-coverage restoration.
| Treatment | Usually Considered For | Tooth Coverage |
| Filling | Small to moderate areas of decay or damage | Restores the damaged area directly |
| Inlay | Moderate damage contained within the cusps | Fits inside the biting surface |
| Onlay | Larger damage involving one or more cusps | Provides partial cuspal coverage |
| Crown | Extensive damage or a significantly weakened tooth | Covers most or all of the visible tooth |
No single treatment is automatically better. The aim is to select the most conservative restoration that can predictably protect and restore the tooth.
What Are Dental Inlays Made From?
Dental inlays can be made from several materials. The most appropriate choice depends on the tooth being treated, the patient’s bite, the amount of remaining structure, appearance and the dentist’s clinical assessment.
Porcelain or ceramic inlays
Porcelain and ceramic inlays can be matched to the colour of the surrounding tooth. They are commonly selected where appearance is important and can provide a strong, accurately fitting restoration in suitable cases.
Different ceramic materials have different properties, so the choice depends on factors such as the position of the tooth, restoration thickness and chewing forces.
Gold inlays
Gold inlays are durable and can perform well over long periods. They are less commonly chosen today because the metal is visible, but they may still be considered for back teeth where appearance is less important.
Composite resin inlays
Composite resin inlays are also tooth-coloured. Their expected performance depends on the material, design, position of the tooth, available thickness and the forces placed on the restoration.
The dentist should explain the advantages and limitations of the available materials before treatment begins.
How Is a Dental Inlay Fitted?
Dental inlays are commonly fitted over two appointments, although some practices may use digital systems that allow selected restorations to be produced differently.
1. Examination and assessment
The dentist examines the tooth, gums and bite. X-rays may be taken to assess decay, existing restorations, the roots and the health of the tooth underneath.
Any active decay, infection or gum problems may need to be treated before the final restoration is fitted.
2. Preparing the tooth
Local anaesthetic may be used before the dentist removes decay, old filling material and unsupported tooth structure.
The tooth is then shaped to create enough space and support for the inlay.
3. Taking an impression or digital scan
An impression or digital scan records the prepared tooth, neighbouring teeth and the patient’s bite.
This information is used to design and manufacture the custom restoration.
4. Placing a temporary restoration
A temporary filling may be used to protect the prepared tooth while the final inlay is being made.
Temporary restorations are less durable than the final inlay, so patients may be advised to avoid particularly hard or sticky foods.
5. Fitting the final inlay
At the fitting appointment, the temporary restoration is removed and the tooth is cleaned.
The dentist checks:
- The accuracy of the fit
- Contact with neighbouring teeth
- The shape and appearance
- The patient’s bite
- Whether the area can be cleaned effectively
The inlay is then bonded securely into the tooth and polished. The bite is checked again and adjusted where necessary.
Does Getting a Dental Inlay Hurt?
Local anaesthetic is normally used while the tooth is being prepared, so significant pain is not expected during treatment.
Patients may notice pressure, vibration or temporary gum tenderness. The tooth may also feel sensitive to temperature or pressure for a short period after preparation or fitting.
Persistent pain, worsening sensitivity or discomfort when biting should be assessed. These symptoms may relate to the bite, a crack, the bond or a problem affecting the nerve inside the tooth.
In selected cases, root canal treatment may be required, although sensitivity after an inlay does not automatically mean that the nerve has been permanently damaged.
Benefits of Dental Inlays
In suitable cases, an inlay can provide a durable and accurately fitting alternative to a large direct filling while preserving more healthy tooth structure than a crown.
Potential benefits include:
- A custom-made fit
- Preservation of healthy enamel and dentine
- Restoration of the damaged biting surface
- Improved contact with neighbouring teeth
- Tooth-coloured material options
- Resistance to everyday chewing forces in suitable cases
- The ability to restore function without covering the entire tooth
The result still depends on appropriate case selection, accurate preparation, reliable bonding and a carefully checked bite.
Disadvantages and Risks of Dental Inlays
Dental inlays are not suitable for every damaged tooth.
Possible disadvantages and risks include:
- They normally cost more than a standard direct filling
- They may require more than one appointment
- The tooth may be temporarily sensitive
- The inlay can chip, fracture or become loose
- Decay can develop around or underneath the margins
- The supporting tooth can crack or weaken
- The bite may require adjustment
- The tooth may later require additional treatment
If the tooth is extensively cracked, heavily damaged or unable to support an inlay, a crown or another restoration may provide a more predictable result.
Can a Dental Inlay Fall Out?
A dental inlay can become loose or detach if the bond deteriorates, decay develops underneath it or the restoration is exposed to excessive pressure.
Other possible causes include:
- Grinding or clenching
- An uneven bite
- Loss of supporting tooth structure
- A fracture in the tooth or restoration
- Chewing particularly hard or sticky foods
Do not attempt to glue an inlay back into place at home. Keep the restoration safe and arrange a dental appointment. The exposed tooth may be sensitive or vulnerable to additional damage.
Can Decay Develop Under an Inlay?
The restoration itself cannot develop tooth decay, but the natural tooth can still decay around the margins or underneath a defective inlay.
The risk may increase where:
- Plaque collects around the edge
- The margin becomes damaged or difficult to clean
- The bond deteriorates
- Sugary foods or drinks are consumed frequently
- Oral hygiene is poor
- Regular examinations are missed
Decay underneath an inlay may not always be visible to the patient. Routine dental examinations allow the dentist to assess the margins, supporting tooth and surrounding gums.
How Long Do Dental Inlays Last?
A well-made dental inlay can remain functional for many years, but there is no guaranteed lifespan.
Longevity depends on:
- The material used
- The amount of healthy tooth remaining
- The fit and bonding of the restoration
- The patient’s bite
- Grinding or clenching
- Oral hygiene
- Diet and habits
- Regular dental maintenance
Gold and ceramic inlays can both provide durable restorations in appropriately selected cases. However, the condition of the natural tooth remains just as important as the material itself.
No dental restoration lasts forever. Regular monitoring allows signs of wear, decay, loosening or bite problems to be identified early.
How to Care for a Dental Inlay
A dental inlay should be maintained in much the same way as a natural tooth.
- Brush twice daily with fluoride toothpaste.
- Clean between the teeth every day.
- Attend regular dental examinations.
- Attend dental hygiene appointments where advised.
- Avoid chewing ice, pens and other hard objects.
- Do not use restored teeth to open packaging.
- Wear a night guard if recommended for grinding or clenching.
- Arrange an appointment if the bite feels high or uneven.
- Report pain, sensitivity or looseness promptly.
Signs That a Dental Inlay Needs Attention
Arrange a dental assessment if:
- The inlay feels loose
- The tooth becomes persistently sensitive
- There is pain when chewing
- The bite feels high or uneven
- The restoration appears chipped or cracked
- The edge feels rough
- Floss repeatedly catches or tears
- Food becomes trapped around the tooth
- The surrounding gum becomes sore or inflamed
- The restoration falls out
Early assessment may allow a minor issue to be repaired before more extensive treatment is required.
Are Dental Inlays Worth It?
A dental inlay may be worth considering when a tooth requires more support than a direct filling can provide but does not need cuspal coverage or a full crown.
It may be particularly useful where the cusps and outer walls remain strong but the central biting surface requires a custom-made restoration.
However, an inlay is not automatically the best option for every damaged tooth. The decision should be based on:
- The size and position of the damage
- The condition of the remaining enamel and dentine
- Whether cracks are present
- The health of the nerve
- The patient’s bite
- The expected ability to maintain the restoration
Questions to Ask Before Getting a Dental Inlay
- Why is an inlay recommended instead of a filling?
- Are the tooth’s cusps strong enough to remain uncovered?
- Would an onlay or crown provide a more predictable result?
- Which material will be used?
- How much healthy tooth structure will be removed?
- Is there any evidence of cracking?
- How will the restoration affect my bite?
- What maintenance may be required?
- What happens if the inlay becomes loose or fractured?
Why Choose Glow Dental for a Dental Inlay?
At Glow Dental, restorative treatment begins with an assessment of the damaged tooth, remaining enamel and dentine, gum health and the patient’s bite.
We consider whether a filling, inlay, onlay or crown can provide appropriate protection while preserving as much healthy tooth structure as possible.
Where an inlay is suitable, we explain the preparation involved, the available materials, the expected treatment stages and how the restoration should be maintained.
Book a Dental Inlay Assessment at Glow Dental
Whether an inlay is suitable depends on the size and location of the damage, the strength of the remaining tooth and the forces placed on it.
Glow Dental provides assessments for fillings, inlays, onlays and crowns at our practice on Northcote Road in Battersea, close to Clapham Junction. We also welcome patients from Clapham, Wandsworth, Chelsea and surrounding areas of South West London.
During your appointment, we can assess the tooth and explain which restorative option may provide the most appropriate balance of strength, appearance and tooth preservation.
Patients visiting the practice for the first time can read more on our new patient information page.
Written by:
Glow Dental
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