Conservative restorative dentistry in Cheney, Washington
Tooth-colored fillings in Cheney.
Repair only what the tooth needs.
A small cavity may be restored with a direct composite filling. When damage is larger but the tooth does not need full coverage, a bonded ceramic inlay or onlay may preserve more natural structure than a crown. Dr. Chris Collins evaluates the decay, remaining enamel, bite, and symptoms before recommending the most conservative predictable repair.
Early decay may have no symptoms. An examination and appropriate imaging are the reliable way to determine whether a tooth needs treatment.
THREE SCALESDIRECT · PARTIAL COVERAGE · FULL COVERAGE
What are fillings, inlays, and onlays?
Restorations that replace damaged tooth structure—
scaled to the size and location of the problem.
A filling repairs a cavity after decayed tooth tissue is removed. A direct composite filling is shaped and hardened in the tooth during the appointment. An inlay is a custom restoration that fits within the chewing surface, while an onlay extends over one or more cusps when those raised areas also need rebuilding.23
These options overlap, but they are not interchangeable. A smaller cavity may be well suited to composite. A larger defect may benefit from a bonded ceramic inlay or onlay. If the tooth is too structurally compromised for partial coverage, a dental crown may be more predictable.
Explore restorative dentistry in Cheney ↗When to schedule an evaluation
Tooth decay often starts quietly.
Symptoms tend to appear as it advances.
Early decay may cause no symptoms. White, brown, or black staining, a visible hole, tooth sensitivity, toothache, food trapping, swelling, or a damaged existing filling deserve professional evaluation. X-rays may reveal decay that cannot be seen directly.1
A chalky white spot appears
A white spot can mark early enamel demineralization. Before a hole forms, fluoride, improved plaque control, dietary changes, and risk-based preventive care may sometimes stop or reverse the process.1
A tooth develops brown, gray, or black staining
Discoloration can have several causes, including decay, staining, cracks, or an existing restoration. Color alone cannot confirm a cavity, but a new or changing spot should be examined.
You see or feel a hole or rough edge
Once enamel has broken down into a cavity, the damage is permanent and generally needs a restoration. A rough area can also be a chipped filling, fracture, or tartar, so diagnosis matters.
Food repeatedly catches in the same place
A cavity, open contact, cracked tooth, worn filling, or gum change can create a food trap. Treating the cause can protect the tooth and nearby gum tissue.
Sweet, cold, heat, or pressure triggers pain
Advancing decay may cause sensitivity or toothache. Sensitivity can also come from recession, grinding, cracks, or a leaking restoration, so an exam is needed before choosing treatment.
An old filling feels loose, chipped, or different
A damaged restoration can expose the tooth to plaque, food, or fracture. The team will determine whether the filling can be repaired, needs replacement, or requires a different restoration.
Swelling, fever, or persistent spontaneous pain develops
Facial swelling, fever, drainage, or severe persistent pain may indicate infection and should be evaluated promptly. A filling alone may not be enough if the pulp or surrounding tissues are involved.
The restorative appointment
From diagnosis to a smooth, functional repair—
with the least coverage the tooth can predictably support.
Direct composite and indirect ceramic restorations follow different workflows. A qualifying ceramic inlay or onlay may be scanned, designed, milled, and bonded with the office’s CEREC® system in one coordinated visit.5
Confirm whether the tooth has decay, fracture, or a failing restoration
Dr. Collins examines the tooth, symptoms, neighboring contacts, gums, and bite. Appropriate X-rays may help determine the depth and extent of damage.
Keep the treatment area comfortable
Local anesthesia is used when needed. The team explains the plan, checks comfort, and isolates the tooth so the restorative material can be placed under controlled conditions.
Remove decay and preserve sound structure
Compromised tissue and defective material are removed. The preparation is shaped according to whether the tooth will receive composite, an inlay, an onlay, or another restoration.
Place composite or design the ceramic restoration
Composite is applied, shaped, and light-cured directly. For a ceramic inlay or onlay, a digital scan is used to design a restoration that fits the prepared tooth, contacts, and bite.
Mill, cure, polish, or characterize the restoration
A ceramic restoration is milled from a selected block and may be polished, characterized, glazed, or fired. Composite is contoured and polished to create smooth margins and anatomy.
Check the seal, contacts, and bite
The restoration is bonded or secured, then Dr. Collins checks the bite and makes final adjustments. You receive instructions for numbness, sensitivity, cleaning, and when to call.
“Same-day” applies to many qualifying chairside ceramic cases, not every tooth. Deep decay, pulp symptoms, difficult isolation, cracks, complex material needs, or another diagnosis can change the treatment and timeline.
Choosing the restoration
The best option is not the biggest restoration.
It is the smallest one likely to last in that situation.
Location, cavity size, remaining enamel, cusp strength, bite forces, grinding, moisture control, appearance goals, cost, and maintenance all influence the plan. Every material has advantages and limitations.4
Tooth-colored composite filling
Composite resin contains an acrylic resin reinforced with glass filler. It can be shade-matched, placed directly, and light-cured in layers. It often allows conservative tooth preparation, but moisture control and the size and location of the restoration matter.4
- Often suited to small and moderate direct repairs
- Completed directly in the prepared tooth
- Repairability, wear, staining, and fracture risk vary by case
Bonded ceramic inlay
An inlay is made outside the mouth or through a chairside digital workflow, then bonded into the prepared tooth. It stays within the cusps and may be considered when a direct filling is not ideal but the cusps remain supportable.
- Custom fit and chewing-surface anatomy
- Tooth-colored ceramic or another suitable material
- Preserves cusps that do not require coverage
Bonded ceramic onlay
An onlay extends onto one or more cusps to replace weakened or missing tooth structure. It can provide broader reinforcement than an inlay while preserving portions of the tooth that do not need a full crown.
- Covers selected weakened cusps
- May be used for larger defects or failing restorations
- Requires enough sound structure for a predictable bonded design
The conservative-restoration spectrum
Match the coverage to the damage.
Protect the tooth without overtreating it.
A visual cavity size does not tell the whole story. Cracks, undermined cusps, previous fillings, remaining enamel, symptoms, and bite can move a tooth toward a larger or smaller restoration.
Preventive care
Early enamel mineral loss may sometimes be arrested or reversed with fluoride and risk-factor control before restorative treatment is needed.
Preventive dentistry ↗Composite filling
Used when the tooth can support a direct restoration and the preparation can be isolated and bonded predictably.
Evaluate a cavity ↗Inlay or onlay
A custom bonded restoration for a larger defect when selected tooth structure and cusps can still be preserved.
See the workflow ↓Dental crown
Considered when extensive damage, fracture, root canal treatment, or structural weakness makes broader coverage more predictable.
Dental crowns in Cheney ↗
Replacing an old filling
An existing filling should be replaced because it needs treatment—
not simply because it is old or silver-colored.
A restoration may need attention when it is fractured, loose, worn, leaking, associated with new decay, creating a food trap, or no longer supporting the tooth. The FDA does not recommend removing an intact amalgam filling with no decay beneath it solely to prevent disease, because removal can sacrifice healthy tooth structure.4
An intact restoration may be monitored. A localized defect may sometimes be repaired rather than replacing the entire filling, depending on the material and tooth.
New decay, fracture, a failing margin, weakened cusps, or extensive loss may call for composite, a ceramic inlay or onlay, or a crown.
Restorative dentistry close to home
Digital tools can create the restoration.
Clinical judgment decides how much tooth to preserve.
Dr. Chris Collins evaluates more than the visible cavity. He considers symptoms, X-rays, previous restorations, remaining enamel, cusp support, bite, grinding, and whether the tooth can be isolated for reliable bonding. The aim is a repair that feels comfortable and remains maintainable.
Collins Family Dentistry has served Cheney families since 1970. The practice uses CEREC CAD/CAM technology to design and manufacture crowns, inlays, and certain bridges in the office, reducing laboratory steps for many qualifying cases.6

“The right restoration should remove disease, restore function, and preserve every part of the tooth we can responsibly keep.
Protecting the repair
A restoration repairs the damage.
Daily habits help protect the tooth around it.
Fillings, inlays, and onlays do not last a lifetime in every case. Their service life depends on material, restoration size, bite, grinding, diet, hygiene, decay risk, tooth structure, and preventive care.2
Brush with fluoride toothpaste
Brush twice daily and clean between teeth. Fluoride and plaque control help protect exposed tooth surfaces and restoration margins.
Reduce frequent sugar and acid exposure
How often teeth are exposed to fermentable carbohydrates and acidic drinks affects demineralization. Water and balanced meals are kinder to enamel than frequent sipping or snacking.
Protect against grinding and hard objects
Do not use teeth as tools. A nightguard may be recommended when clenching or grinding places restorations and teeth under excessive force.
Keep risk-based checkups
Exams and appropriate X-rays help monitor margins, recurrent decay, cracks, contact areas, gums, and changes in the bite.
Call when pain does not settle
Temporary sensitivity or gum tenderness can occur. Contact the office if the bite feels high, the restoration feels loose, sensitivity worsens, pain becomes spontaneous, or swelling develops.
Call (509) 235-8451 ↗A family’s experience
“They used really good numbing gel and she didn’t even cry. I have recommended them to friends.”
Comfort, clear explanations, appropriate anesthesia, and a calm pace are part of treating cavities—not extras added afterward.
Read patient testimonials ↗Frequently asked questions
Questions worth asking
before restoring a tooth.
These answers provide general education. An examination and imaging determine whether a specific tooth needs preventive care, a filling, an inlay, an onlay, a crown, root canal therapy, or another treatment.
01What is the difference between a filling, an inlay, and an onlay?
A direct filling is placed and hardened in the prepared tooth during the appointment. An inlay is a custom restoration that fits within the tooth’s cusps. An onlay extends over one or more cusps when those areas also need rebuilding. The amount and location of damage determine which design is appropriate.
02How do I know whether I have a cavity?
Early tooth decay often has no symptoms. As it advances, possible signs include white, brown, or black areas, a visible hole, sensitivity to sweets or temperature, toothache, or food trapping. Other dental problems can cause similar symptoms, so diagnosis requires a dental examination and sometimes X-rays.
03Can early tooth decay be reversed without a filling?
Before a cavity forms, early enamel mineral loss may sometimes be stopped or reversed through fluoride, improved plaque control, dietary changes, and other risk-based preventive measures. Once enamel has broken down into a hole, the damage is permanent and generally needs restoration.
04Are composite fillings tooth-colored?
Yes. Composite resin can be selected in a shade that blends with surrounding tooth structure. It is an acrylic resin reinforced with glass filler and is commonly hardened in layers with a curing light. Shade is only one factor; cavity location, size, isolation, bite, and remaining structure also affect the recommendation.
05Can Collins Family Dentistry make ceramic inlays and onlays in one visit?
Many qualifying ceramic inlays and onlays may be digitally scanned, designed, milled, finished, and bonded with the office’s CEREC system in one coordinated visit. Deep decay, difficult isolation, cracks, complex material needs, or another diagnosis may require a different workflow or additional visits.
06Does getting a dental filling hurt?
Local anesthesia is used when needed to numb the tooth and surrounding tissue. You may notice pressure or vibration, but treatment should not be sharply painful. Temporary sensitivity can occur afterward. Persistent or increasing pain should be evaluated.
07Should I replace an intact silver amalgam filling?
Not automatically. The FDA does not recommend removing an amalgam filling that is in good condition with no decay beneath it solely to prevent disease, unless removal is considered medically necessary. Replacement may be discussed when a restoration is defective, fractured, associated with decay, causing symptoms, or otherwise clinically indicated.
08How long do fillings, inlays, and onlays last?
There is no guaranteed lifespan. Longevity varies with material, restoration size, cavity location, remaining tooth structure, bite forces, grinding, diet, oral hygiene, decay risk, and preventive care. Any restoration can eventually need repair or replacement.
09When would I need a crown instead of an inlay or onlay?
A crown may be recommended when decay, fracture, an old restoration, root canal treatment, or structural loss leaves the tooth unable to support a partial-coverage restoration predictably. When enough healthy structure remains, an inlay or onlay may preserve more natural tooth than full coverage.
10How much do fillings, inlays, and onlays cost in Cheney?
Cost depends on the tooth, restoration type and material, cavity size, diagnostic needs, whether other treatment is required, insurance benefits, and case complexity. The office can provide an individualized estimate after examining the tooth and reviewing the treatment plan.
Clinical and practice references
Information built on
credible patient resources.
- 01National Institute of Dental and Craniofacial Research
Tooth Decay—causes, early mineral loss, symptoms, diagnosis, treatment, fluoride, and prevention.
Review source ↗ - 02National Institute of Dental and Craniofacial Research
Dental Fillings—how cavities are repaired, common materials, crowns, and the need for future maintenance.
Review source ↗ - 03American College of Prosthodontists
Inlays and Onlays—definitions, tooth-colored materials, bonding, and cusp coverage.
Review source ↗ - 04U.S. Food and Drug Administration
Dental filling materials, composite resin considerations, dental amalgam, and guidance regarding intact amalgam removal.
Review source ↗ - 05Dentsply Sirona
CEREC digital chairside workflows for crowns, inlays, and onlays.
Review source ↗ - 06Collins Family Dentistry
Official practice information regarding fillings, ceramic inlays and onlays, CEREC technology, location, and hours.
Review source ↗
Tooth-colored restorations close to home
Repair a cavity
without leaving Cheney.
Collins Family Dentistry provides preventive and restorative care from 1st Street near Cheney Spokane Road. Call about tooth sensitivity, a visible cavity, a chipped or loose filling, food trapping, or a planned ceramic inlay or onlay.
- Monday
- 8:00 AM–2:30 PM
- Tuesday
- 8:00 AM–4:00 PM
- Wednesday
- 8:00 AM–2:30 PM
- Thursday
- 8:00 AM–2:30 PM
- Friday
- 8:00 AM–2:30 PM