A veneer is a custom lab-made restoration used to cover the face of front tooth to change the shape of tooth to a more pleasing design or protect the tooth as it is heavily filled but it does not enough to merit a crown. An inlay is a custom lab-made restoration used to "fill" a large cavity in a back tooth. It is a stronger and stiffer material which can withstand the large crushing forces generated by back teeth unlike a large composite filling. An onlay is custom lab-made restoration used to "fill" a large cavity when one or cusp( pointed peak of a back tooth is missing or weak in a back tooth. A cusp is a high stress point of a tooth. If it is inappropriately restored with a filling material this can result in overloading of the remaining tooth; a change in the bite by allowing the opposing tooth to wear away the filling and moving into the resultant gap. The end result may well be catastrophic fracture of the tooth. An overlay is custom lab-made restoration used to "fill" a large cavity when all the cusps are compromised/weak but there is sufficient tooth structure such that using a crown would be very destructive.

There can be a number of reasons for discoloured/stained teeth. It is essential that the reason for this be determined so that the most conservative solution to address this be undertaken. If the staining is superficial this can be addressed by GBT therapy. If this discolouration is actually through the structure of the tooth then this can be addressed by the appropriate whitening therapy solution. However, if the tooth is stained and heavily restored and there is an increased risk of tooth fracture the an inlays/onlays/overlays/veneers would be a great solution to address these issues. If the teeth are very heavily stained this needs to be addressed by tooth whitening* otherwise this will need to be masked by using opaque ceramic resulting in a less "alive" outcome to the custom made restoration.

Provided that the inlay/onlay/overlay/veneer has been accurately made and fitted then it there is less likelihood for the tooth underneath rotting away. This is assuming that the joint between the inlay/onlay/overlay/veneer and the tooth is being actively cleaned with a tooth brush and floss.

Dental inlays/onlays/overlays/veneers can be be custom made with a number of different materials. Gold - this is still an excellent choice for back teeth as it can be thin and very conservative. However it is not very aesthetic. Pressed ceramic - this is now the first choice for high aesthetics, whether front or back teeth. The advent of 3D scanning technology* has really allowed this to push boundaries. A prepped tooth can be 3D scanned and the data sent to a Digital lab where a new tooth can be designed using CADCAM technology. The tooth inlay/onlay/overlay/veneer can then be milled before arriving at the master ceramist who will then use tint artistry to recreate the colours of your natural surrounding teeth from the photographs sent with the work. Using clever polishing techniques the ceramist can also copy how light reflects of your natural teeth. Done well it is very difficult to distinguish the inlay/onlay/overlay/veneer from the natural teeth. These inlays/onlays/overlays/veneers are technique sensitive to fit as they need to be bonded to the underlying tooth without moisture contamination. Monolithic Zirconia - milled industrial diamond which can be very thin and stronger than metal. Ideal for back teeth but as colour technology and techniques continue to develop an excellent choice for close to the front of the mouth. These are less techniques sensitive to fit so less complications. Cerec inlays/onlays/overlays/veneers - scan a tooth and mill the inlays/onlays/overlays/veneers within an hour. A great technology with the benefit that you don't need to wait 2 weeks for the lab to make the inlays/onlays/overlays/veneers. However, still no where near as good as that made by a skilled, experienced ceramist.

Whilst it may seem that the same crowns are being offered for different fees at different clinics, this is not always the case. To create a perfect inlay/onlay/overlay/veneer is much more than the material. It is based on the skill of the dentist to carefully and conservatively prepare the tooth and then accurately capture the prep data for the lab; clear instructions to the lab which discuss colour gradients (teeth have a number of colours), the appropriate material for that particular client in terms of their bite and their expectations, a skilled experienced master ceramist who devotes sufficient time to recreate a inlay/onlay/overlay is as slender as a natural tooth and looks alive. The ceramist has to ensure that not only does the crown look like a tooth but it fits accurately to minimise ledges for bacteria; hygienic to allow cleaning; good contact points with adjacent teeth to ensure that food/debris and bacteria do not end up rotting the gum and eventually the jawbone. This requires time, experience and skill from both the dentist and the ceramist to achieve consistent out standing results. This is reflected in the fees.

Nothing in dentistry is permanent. How long it lasts depends on how well the tooth has been prepped and the inlay/onlay/overlay made and fitted. Just as important is how well you consistently clean around the tooth/- inlay/onlay/overlay/veneer joint to minimise bacteria stagnating around this important interface.

Whilst not all teeth protected by inlays/onlays/overlays/veneers need to be root treated, teeth that are usually covered in this way are heavily compromised and have a higher risk of dying. The dental literature quotes an increased risk of 18% of tooth dying following being covered by these lab made restorations. However, leaving the tooth unprotected without these restorations may risk a catastrophic fracture which may result in tooth loss.

A tooth is at it's strongest when it is whole. When teeth rot or are repaired/restored with filling materials these teeth are still required to withstand the same heavy loads but with less surface area. This increases the risk of the tooth fracturing especially with heavily filled teeth. One of the ways to protect the tooth is to remove a outer layer of the tooth and filling and have a lab custom make a skin which covers the remaining tooth and fits like a glove.