Facing a damaged tooth can leave you with questions about the best restoration option. When significant decay or damage occurs, your dentist may recommend either an onlay or a crown—but understanding which treatment is right for your situation can be challenging. Both restorations serve important functions, but they differ in how much natural tooth structure they preserve and when they’re most appropriate.
At Ocean Breeze Prosthodontics, we believe that preserving your natural teeth whenever possible leads to better long-term oral health. This guide will help you understand the key differences between onlays and crowns, and when one might be the better choice for your specific situation.
What is an Onlay?
An onlay is a custom-made restoration that covers the damaged portion of your tooth, including one or more cusps (the pointed parts of your tooth’s chewing surface). Unlike fillings, which are molded directly in your mouth, onlays are fabricated in a dental laboratory from porcelain, composite resin, or gold, then bonded to your tooth during a separate appointment.
The primary advantage of an onlay is preservation of tooth structure. Since onlays only replace the damaged portion, your healthy tooth structure remains intact. This preservation contributes to the tooth’s overall strength and longevity.
What is a Crown?
A dental crown is a cap that covers the entire visible portion of your tooth above the gumline. Crowns require more tooth reduction than onlays, as they encase the entire tooth structure. Made from materials similar to onlays, crowns provide protection for severely damaged teeth and can strengthen teeth that might otherwise fracture.
When to Choose an Onlay
An onlay may be your best option when:
- You have damage limited to the cusps or chewing surface
- Your tooth has a large cavity that’s too extensive for a filling
- The damage affects only a portion of your tooth, leaving significant healthy structure
- You want to preserve as much natural tooth structure as possible
- Your tooth needs strength beyond what a filling can provide, but doesn’t require a full crown
Onlays offer several benefits, including the preservation of healthy tooth structure, less invasive preparation, and excellent durability. They’re particularly ideal for teeth with moderate damage that doesn’t compromise the overall tooth integrity.
When a Crown Is Necessary
A crown is typically recommended when:
- Your tooth has significant damage affecting most of its structure
- A large portion of your tooth is decayed or fractured
- You’ve had root canal treatment, which can weaken the tooth
- Your tooth has a crack that extends below the chewing surface
- You need to prevent fracture of a severely weakened tooth
- The tooth needs major changes in shape or alignment
Crowns provide comprehensive protection and strength for teeth with extensive damage. While they require more tooth reduction, they’re sometimes the only way to save a tooth that might otherwise require extraction.
The Decision Process
When determining whether an onlay or crown is right for you, several factors come into play:
Extent of Damage: The primary consideration is how much of your tooth is affected. Onlays are ideal for moderate damage, while crowns are necessary for extensive damage.
Remaining Tooth Structure: If you have significant healthy tooth structure, an onlay helps preserve this natural strength.
Functional Requirements: Teeth that bear heavy chewing forces might need the full coverage of a crown, especially if they’re already weakened.
Aesthetic Considerations: Both restorations can be made to match your natural teeth, but the visibility of the tooth may influence which option provides the best cosmetic result.
Long-term Prognosis: Sometimes a tooth’s long-term health is better served by a crown, despite an onlay being an option in the short term.
Both onlays and crowns can provide years of function when properly cared for. Regular dental checkups, diligent oral hygiene, and avoiding habits like chewing ice or using teeth as tools will help extend the life of your restoration.
Schedule Your Appointment With Our Dedicated Team Today
At Ocean Breeze Prosthodontics, Dr. Trinh leverages extensive training in prosthodontics—a specialty focused on tooth restoration and replacement—to provide personalized treatment recommendations. With over 15 years of combined experience, our team can evaluate your specific situation and help you understand whether an onlay or crown will better serve your oral health goals. If you’re facing tooth damage and considering your restoration options, contact our Delray Beach office at (561) 265-1998 or schedule a consultation through our contact form. We’ll help you choose the option that best preserves your tooth structure while providing the protection and function you need.
