My dentist tried to mend my cracked tooth with bonding, but it didn’t work. Now she wants to try and onlay. Is it worth it, or should I get a crown? – Thanks. Evan

Evan

A cosmetic dentist will need to thoroughly examine your tooth and take an X-ray to accurately determine the extent of the crack.

What Is the Treatment for a Cracked Tooth?

Appropriate treatment for a cracked tooth depends on various factors, including the crack’s extent, location, and severity.

• The extent of the crack: Cracks can range from superficial enamel cracks to deeper cracks extending into the dentin (the layer beneath the enamel) or even the pulp (the living tissue inside the tooth).
• Location of the crack: Cracks can be either horizontal or vertical.
• Crack or fracture: If any part of the tooth moves independently, it is considered a fracture. Prompt treatment is necessary to prevent further damage.

Can an Onlay Work Repair a Cracked Tooth?

Onlays come in various types, some suitable for most cracks while others have limitations. Gold and zirconia onlays are known for their strength and ability to withstand the biting forces of your teeth.

What Is an Onlay?

An onlay is a custom-made dental restoration, typically made from ceramic, gold, or hardened composite, that covers a significant portion or all the chewing surface of your tooth. Many advanced cosmetic dentists prefer onlays over dental crowns for specific applications. To create an onlay, your dentist will take impressions of your tooth, and a custom restoration will be fabricated to fit your tooth precisely. This procedure requires specialized skills and advanced cosmetic dentistry training.

• Gold onlay: A gold onlay can cover the entire chewing surface of your tooth, effectively preventing the crack from spreading.
• Porcelain or ceramic onlay: All-porcelain onlays are suitable for minor cracks that affect a tooth’s cusp or corner. However, porcelain may not be sufficiently strong to hold a molar tooth together. Zirconia, a high-strength dental ceramic, offers greater strength and durability than all-porcelain onlays. Advanced cosmetic dentists often utilize zirconia onlays to preserve teeth.
• Hardened composite onlay: While less durable than porcelain, a hardened composite onlay may not be strong enough to protect a crack in a molar tooth.

We recommend getting a second opinion from a cosmetic dentist trained in occlusion and bite. They will explain your options for a restoration that fits well, protects your tooth, and prevents the crack from worsening.

Dr. Miranda Lacy, a Plano, Texas dentist, sponsors this post.