My dentist wants to put a porcelain onlay on my tooth. What are porcelain onlays?
How porcelain onlays differ from crowns
A crown covers the entire chewing surface of the tooth and wraps around the entire tooth, all the way to the gum line. The porcelain onlay is more conservative. It covers only those parts of the tooth that are weak and it will not go down to the gumline.
Advantages of porcelain onlays
One advantage of porcelain onlays are that they preserve more of the natural tooth structure. There is a feeling many dentists have that if tooth structure is healthy, it is best to leave it alone if possible.
A second advantage is that, since they don’t go down to the gumline, there is no chance of them irritating the gum. Crowns can cause gum irritation and in some cases can even contribute to gum disease. Also, since they don’t go down to the gumline, it is easier to keep the margin (that line where the porcelain onlay or crown ends and the tooth begins) clean. The margin is out in the open where you can easily brush it. The margin of a crown is the place that is most vulnerable to recurrent decay. Thus, porcelain onlays are less likely to get new tooth decay.
Third, porcelain onlays, being made entirely of porcelain, are very esthetic. They look extremely natural.
To clarify the difference between a porcelain onlay, an inlay, and a crown, here is a diagram. In this case, the porcelain onlay covers both cusps of the tooth, just like the crown does. But the crown will go all the way down to the gumline, where an onlay will not. And an inlay does not cover any cusps but sits entirely inside the tooth.
Porcelain onlays require a great deal of expertise to place correctly. They require extensive training in cosmetic dentistry and in occlusion. We recommend that you only have an expert cosmetic dentist do one. (For referral to an expert cosmetic dentist, see our referral page.)
Second, porcelain onlays made entirely of porcelain are not as strong as gold crowns or porcelain-fused-to-metal crowns, so they can be more susceptible to breaking, although newer ceramics are extremely strong. The chances of breaking are minimized if you are having this done by an expert cosmetic dentist.
For general information on crowns and a comparison of the various choices of crowns and onlays, see our page explaining porcelain crowns compared with other types of crowns.
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