Why? There are many reasons, but the bottom line rationale probably can be summed up with these points….
Habits…Older dentists prefer crowns since they know them best. They are very comfortable practicing their usual ‘drill-em and fill-em’ or (better yet), ‘crown-em’ dentistry.
Less experienced types have learned a similar conventional, yet older, mind-set from well-aged dental school instructors who, likely, are light-years away from state-of –the-art dentistry circa 2010.
Degree of Difficulty... Onlays are technically more demanding and difficult to perform than Crowns. They are harder for the operator to prepare and much more difficult to bond in to place. Therefore, there is a steep learning curve required.
Onlay treatment performed with lesser skills leads to colossal frustration for all involved.
Further, the lab work is much more challenging. Only higher-quality labs will even offer Onlays since they are so much more difficult to make.
Expense… Due to their technical demands, Onlays are more expensive (for the DDS) to perform, especially when they are just starting to learn how to place them. However, for an experienced provider of Onlays the difference is insignificant.
Further, the Lab Fees, as described above, are higher for Onlays. Therefore, it makes sense for an operator to provide the better treatment of Onlays for patients only if skills and experience warrant it.
Note: Cheap foreign-type (Chinese) labs usually will only make Crowns --
THEY WILL NOT EVEN TRY TO MAKE AN ONLAY!
The fabrication of a state-of-the-art Onlay requires the usage of a ultra-strong ceramic material called Lithium-disilicate. This involves the purchase of a very expensive machine and associated materials. Many foreign (cheaper) labs only have the very basic metals and porcelain available to create the traditional crown fused to metal restoration.
Further, since an Onlay (without any metal understructure) is more fracture prone WHEN NOT PROCESSED CORRECTLY OR WHEN NOT BONDED PROPERLY IN THE MOUTH, a lab is leery of its fabrication.
"Speed Dentistry" techniques (quick Drill-em and even quicker Cement-em type Crowns) must NOT be employed.
Otherwise, there will be many fractured Onlays down the road -- and many re-makes for the foreign lab. Thus, since they usually deal with Dentists who are "speed" .... many Foreign, Cheaper Dental Labs will not even attempt to fabricate an Onlay.
A Conservative Onlay preparation removes only the weak, fracture-prone top portion of the tooth – leaving the remaining underlying stronger aspects of the tooth untouched and, thus, more healthy. See Diagram Below...
Benefits of Onlays –
Less Tooth Trauma … Means less chance of creating a Root Canal Problem, now or in the future.
Margins Above the Gum-Line… Means less chance of recurrent cavities, and thus, leading to a longer lasting and healthier restoration.
Healthier Gum Tissue ... Crown margins at or below the gum line may often incite gum inflammation, or worse, more severe forms of Gum Disease.
More Esthetic… Many times with an Onlay we don’t have to cut down the visible side of the tooth and, thus, the Onlay blends in with a nearly “chameleon” type effect. A typical Crown often looks too opaque and fake.
Our Goals at PLAZA HEALTH Dentistry
"We are dedicated to highest quality dentistry offered within a reasonable fee Structure for our valued patients."
Dr. William Schlotz is Committed to be the BEST Cosmetic-Implant Dentist in St. Louis, MO that he possibly can be.
As a Dental Office PLAZA HEALTH Dentistry is on a Quest to become the Best Dental Office offering Cosmetic and Implant Dentistry Services in St. Louis, MO
The above is NOT stated in a manner exhibiting superiority over other Dentists or their chosen method of practice in any way what-so-ever. This would not be ethical. There are many fine dentists in the St. Louis area who don't believe, for whatever reason, in the philosophy stated above. These, likely, are highly competent practitioners who have just chosen to practice dentistry in a different manner from which we believe. This is the nature of a free marketplace of healthcare services.
The above is an endeavor, attempt and effort toward Patient Education ... in order to enhance the knowledge base of the general population and of prospective dental patients in particular. We firmly believe in Patient Education at PHD -- and, consequently, in a thorough process of INFORMED CONSENT.
*Standard Disclaimer and Patient Information per: Missouri State Board Regulations as pertaining to Teeth Whitening, Cosmetic, Sedation & Implant Dentistry...
All are non-specialty interest areas that require no specific educational training to advertise. Drs. Schlotz and Von Rump are GENERAL DENTISTS and are engaged in the practice of GENERAL DENTISTRY in the State Of Missouri. Thus, they are NOT licensed in the specialties of prosthodontics, orthodontics, periodontics or oral-maxillofacial surgery.
TMJ Treatment is a non-specialty area not recognized by the ADA and requires no specific educational training to advertise.
*Standard Disclaimer and Patient Information Regarding Oral Sedation and Dentistry performed under General Anesthesia (commonly referred to as Sleep Dentistry)
Conscious Sedation is taught as part of post graduate residency programs approved by the ADA. Dr. Wm Schlotz and Von Rump have not completed such an ADA approved residency program.
It is a requirement (set forth by the Missouri Dental Board) that a licensed dentist be further licensed (Division of Professional Registration, State of Missouri) to perform oral sedation (aka Enteral Conscious Sedation) in the state of Missouri. Dr. Schlotz and Team have taken the Mandatory Training and Education for this licensure which includes over 20 hrs of training and education in the area of Oral Sedation and Medical Emergency Management. Dr. Schlotz and Team have also taken a 2nd Non-Mandatory course (of 25 hrs) in Oral Sedation and Emergency Medical Management.
Upon this licensure in the field of Oral Sedation, an "Enteral Conscious Sedation Permit" is thereby issued to licensee. Dr. William J. Schlotz has received certification and has been issued License #2009005253.
PLAZA HEALTH Dentistry has received an ENTERAL CONSCIOUS SEDATION SITE CERTIFICATE issued by the Missouri Dental Board (certificate/license #2009004858).
Dr. Schlotz and Von Rump are not providers of Deep Sedation Dentistry (wherein the treating dentist is also responsible for the deep sedation - commonly referred to as "sleep dentistry").
General Dentistry at PLAZA HEALTH Dentistry is performed under General Anesthesia ONLY in concert with Premier Dental Anesthesiology (Board Certified MDs) as the attending caregivers and physicians of the general anesthesia.
PLAZA HEALTH Dentistry has been issued, by the Missouri Dental Board, a DEEP SEDATION/GENERAL ANESTHESIA SITE CERTIFICATE (#2008025661).