Porcelain Onlay - Tooth Preparation:

Going to the dentist is always near the top of my "worst things to do" list. I have had plenty of dental procedures over the years including fillings, crowns and filling replacements. For some reason my back molars have had a tendency to crack which leaves me having to get dental work done. The first few were replaced with crowns about 10 years ago, but the latest technology offers a way to save more of the tooth (which is good) and still keep my mouth in good condition. No one wants to get a tooth pulled or potentially deal with things like root canals. Saving as much of a tooth as possible is the best result you can ask for when having a dentist work on your teeth. I was told that the most recent crack in my molar would probably need a dental crown and perhaps we could try this porcelain onlay procedure and save more of the tooth.

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The cost difference between a crown and a porcelain onlay (we will go into more details down below on price) is not that much different, but the idea of keeping more of my tooth made sense so I choose the porcelain onlay. The first appointment (there are 2) was to prepare the tooth for the temporary onlay and get an impression of my tooth so that a dental laboratory could fabricate the porcelain onlay. After getting numbed up with novacaine, the dentist went to work on drilling out the old filling and taking out other sections of the tooth that had been damaged by the crack. We did not know when he first started drilling if the tooth could be saved since he could not tell how far the crack went down the interior section of the tooth. If it was too deep, then a crown would be necessary. Good news, about 30 minutes into the procedure he said that he could salvage the tooth and continue with the porcelain onlay process. They did quite a bit of cleaning of the tooth, took the impressions of the teeth and then placed in a temporary onlay so that I could still eat and drink foods until my next appointment. I felt slight pressure on my tooth as they did the work, but overall the procedure was not too bad. Take a few Tylenol if you don't like the after effects of dental work. My tooth was definitely hurting a bit for a day as the trauma set in after the novacaine wore off. The temporary onlay was a bit tender when biting on foods and they told me to only eat food that I could cut through with a fork. Avoid things like crunchy potatoe chips, nuts, carrots, anything really hard that could pop out the temporary onlay. I was careful for the 2 weeks before I went back and actually lost a few pounds on this new found diet. The second procedure is less time consuming but still requires you to get numb again as they will be sandblasting the tooth area to make sure the porcelain onlay fits perfectly. There is no more drilling, but the tooth surface needs to be exact and cleaned up before placing the onlay on top. VISIT #2 - The second procedure in this process was much easier. I was numbed up and within 35 minutes I was out of the office. They pulled out the temporary onlay (a little discomfort) and then proceeded to sandblast the remaining tooth area so that all the temporary was gone. I could feel some sensitivity but nothing too extreme. With a quick set of some cement, the new porcelain onlay was in place and they fine tuned it a bit to make sure my "bite" was back to normal. The tooth should be as strong as ever.

Porcelain Onlay Cost:

The biggest thing with any dental work you get is that most likely it's not covered by dental insurance. I haven't had a dental insurance plan for years so this expense was coming straight out of my pocket. A dental crown has run me about $1200 in the past and they are not guaranteed to last more than about 8 to 10 years. You will find yourself replacing them in your lifetime. A porcelain onlay was $1525, although after having had the procedure done I have heard that others have paid anywhere between $1000 and $1500. The potential savings involved is that you don't have to replace an onlay as often as you might with a crown and you protect more of the tooth which means a healthier mouth overall. Some dental insurance might cover 50% of the cost, but be sure to check with your dental coverage before any work is done. Sometimes they make you wait a year or more to get major dental work done if you want it covered. Also, most dentists will work with you on payment options if a one time payment is too much to take. Ultimately, I'm hoping to save money on this process by not having to work on that tooth for well over a decade.

Porcelain Onlay vs Dental Crown:

The first big difference between an onlay and a crown is that the porcelain onlay will be able to save more of the tooth surface. The dental crown is designed to fit over the entire tooth (what was salvaged) while the onlay will cover only the biting surfaces. In my case the old filling was removed and the onlay went inside the tooth cusps. Therefore, the majority of the surrounding tooth surface was saved and is still exposed. The other difference is price. As we mentioned above, the porcelain onlay price was $1525 while the dental crown was closer to $1200. Each dentist may charge a slightly differenct amount, but these are good estimates to go off of. The permanent onlay will feel different than a crown would. My crowns have always had that artificial feel when I rub my tongue against them, but the porcelain onlay feels much more natural and looks great too. I'm hoping that the extra longevity with a porcelain onlay will keep me out of the dentist chair and away from more dental work. I will update this article with any issues/problems that arise with the onlay.

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