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Molar with 50% filling
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Molar with 50% filling

One more question__I moved to a new city and was under care regularily going to a dentist.  When I went to the new dentist, I had new fillings and she replaced some older fillings.  On one she said there was so much decay the molar has 50% filling now and I need a crown.  I was blown away that I needed all this dental work when I had been given a clean bill of health for the past 2 years with my previous dentist.  I was back in my old city and stopped by my older dentist.  He recommended NOT putting a crown on that tooth.  So my question is, would there be another more conservative restorative process other than getting a crown like an onlay / inlay.  Should I wait until this filling needs replaced.  I concerned me when she said she had to drill very deep.  I am concerned that in the future, it's going to cause me more problems.  
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Avatar_dr_m_tn
Again these are legitimate concerns and it is really difficult to give you an opinion. There are definitely more conservative ways of restoring teeth than crowns but that is at the discretion of the dentist. The amount of tooth structure that is present, where the tooth is, your bite etc.If  this tooth has an extensive fiilling it certainly will need futher treatment in the future.When you decide to an inlay or crown placed is a topic for you and your dentist to discuss.
7 Comments
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Avatar_m_tn
sometimes, when fillings are very big, crowns are placed to prevent fractures that might render the tooth non restorable. it's up to the dentist. if you are confued, you should get another opinion (or two) until you are confident.
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Avatar_n_tn
As stated above it is a judgment call which is made by the dentist, IMHO I would always opt to do the conservative restoration but it all depends on which part of the tooth is left.
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Avatar_n_tn
Thanks for the advice.  After 2 opinions, I was told not to crown that tooth.  I have found a new dentist and he is going to put an inlay in for me.  Thanks.  
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Avatar_m_tn
inlay !!!!!!

i dont mean to confuse you, but inlays are my least favorite method to restore (fix) teeth.

1. They weaken teeth because the current hole (where your filling is) in your tooth has to be WIDENED to mke the inlay fit.

2. They CAUSE FRACTURES becasue they act as wedges to split teeth.

3. They (unless they are gold, which I doubt very much) need to be cemented with materials that make teeth very sensitive.

Be very careful. Dentists like to do inlays becasue they are expensive. Ask your dentist why the tooth needs work at all. Ask him to point out the decay to you on a film or with the use of an intraoral camera.
In my opinion, any tooth that "needs an inlay" can also be resored by directly placing a composite (same material as the inlay) in the tooth. This would prevent the need to widen the cavity preparation (hole) and would mean less drilling on healthy tooth structure.

4. Inlays DO  NOT COVER TEETH. They are placed "IN" teeth (hence the name "inlay" and do not protect the tooth at all.

In my practice, if a tooth needs a restoration that involves a laboratory, it is practically always a crown or an onlay. If you were told that the existing filling is 50% of the tooth, and there is something wrong with that filling or there is decay, then in my opinion the tooth should be covered and protected, not weakened by placing another restoration IN" the tooth
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Avatar_m_tn
inlay !!!!!!

i dont mean to confuse you, but inlays are my least favorite method to restore (fix) teeth.

1. They weaken teeth because the current hole (where your filling is) in your tooth has to be WIDENED to mke the inlay fit.

2. They CAUSE FRACTURES becasue they act as wedges to split teeth.

3. They (unless they are gold, which I doubt very much) need to be cemented with materials that make teeth very sensitive.

Be very careful. Dentists like to do inlays becasue they are expensive. Ask your dentist why the tooth needs work at all. Ask him to point out the decay to you on a film or with the use of an intraoral camera.
In my opinion, any tooth that "needs an inlay" can also be resored by directly placing a composite (same material as the inlay) in the tooth. This would prevent the need to widen the cavity preparation (hole) and would mean less drilling on healthy tooth structure.

4. Inlays DO  NOT COVER TEETH. They are placed "IN" teeth (hence the name "inlay" and do not protect the tooth at all.

In my practice, if a tooth needs a restoration that involves a laboratory, it is practically always a crown or an onlay. If you were told that the existing filling is 50% of the tooth, and there is something wrong with that filling or there is decay, then in my opinion the tooth should be covered and protected, not weakened by placing another restoration IN" the tooth
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Avatar_n_tn
okay.  Thanks, I guess I was looking for options to help preserve my tooth.  I have a lot of fillings and inlays seemed like a good idea.  I had a bad gut feeling about the dentist who put in the fillings and was told she did a shoddy job on some of them.  I was surprised that I needed all this work when my dentist in my old city sent me away with a clean bill of health for the last 3-4 appointments.  I kinda of freaks me out to think that when these fillings need replacing there's not going to be much tooth left.  I guess I thought that by getting inlays or onlays I could hopefully save myself from getting root canals and other more expensive procedures in the future.  Since the filling was just put in it probably wont need replacing soon.  
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