CDEN0109

22 I I opinion _ inlays & onlays _There are many prominent teaching clini- cians who feel that inlays and onlays (of whatever colour) are a grossly underutilised restoration, and that crowns are an overutilised restoration.1–3 Ithinkitisworthwhiletoexaminesomeofthepos- siblereasonsforthisunfortunatesituation(forour patients’sake)andseeifthereasonsfordentists’re- luctance to incorporate these restorations into their routine services are really valid today. Reason No. 1: Large amalgam fillings are easier andmoreaffordablethaninlaysandonlays. Both terms—easier, affordable—are relative. Whether something is easy or not in dentistry de- pends on your training and how often you’ve done it. Our first amalgam filling or crown in dental school wasn’t easy either. As for affordable, isn’t that for the patient to decide? People generally buy whattheywantorwhattheyperceiveisintheirbest interest. ReasonNo.2:It’sjusteasiertodoacrownthanan onlay. Same response as above. However, I will agree that when doing a crown, the clinician isn’t faced with the decision of which cusps to keep and which to remove—you just unthinkingly remove them all. But as practitioners, we have to ask, are we deserv- ing of patients’ trust and their money by only rec- ommending that which we perceive (possibly be- cause of lack of training or practice) as expedient? ReasonNo.3:Inlaysandonlaysareexpensive. Not any more than crowns or root canals! We havenotroublerecommendingtheseserviceswhen theyareindicated.Maybeitwouldbeeasierforden- tists to accept and recommend these restorations if an onlay (gold or tooth coloured) was referred to, and thought of, as a partial crown and carried the same fee as a crown. Fig. 1_Fractured cusp, no caries present. Fig. 2_Indirect resin composite onlay at 15 years. cosmeticdentistry 1_2009 Aesthetic inlays and onlays: The coming of age Author_ Ronald D. Jackson, USA Fig. 1 Fig. 2