Composite Filling, Onlay (3/4 Crown) or Full Crown-which do i choose?

A photo and x-rays would really be helpful in your case, but I can provide limited recommendations, based on your brief description.Composite fillings:  I generally tell my patients that composite fillings are not the best choice for posterior teeth.  Composite stains very easily and is known to leak within a few years.  This could lead to more cavities and the need for fillings to be redone and often times may require a root canal of the tooth.  So, if you decide to get composite fillings on your rear teeth, you should consider the fix only temporary.Onlays vs Full Crowns:Onlays are a better option than composite fillings on posterior teeth, but if they are used to cover more than one cusp, I would recommend having a full crown placed instead.  This is because crowns typically provide far more surface area and far less areas that could leak.  The costs of Crowns and Onlays are about the same.  Structurally, crowns provide a stronger covering over your tooth than an onlay.Good luck and I hope this helps. Follow me if you have more questions.Sarah Thompson, DMD

I can give you some ideas on how most (but not all) dentists think when it comes to doing the best dentistry for their patients.  However, to give you any kind of actual diagnosis and treatment plan would require not only seeing x-rays, but also high quality photos or an actual dental examination.That being said, here are some "general" guidelines that many dentists follow when diagnosing restorations based on having large broken down fillings, decay or tooth breakage (fracture).If the whole tooth is in tact, and only has a small or medium size filling (mercury or composite) or small decay, on the top portion of the tooth (called "occlusal" surface), then direct composite fillings are usually adequate.If the involved area is larger than 1/2 the size of the tooth on the top of it, or the fillings or decay goes over one or two other sides of the teeth, then onlays or 3/4 crowns are generally the treatment of choice.If there is a substantial problem with the tooth, overly large existing filling that has allowed significant weakeness, much decay, or fractures lines or actual fracture of one of the cusps, then full crowns will usually be needed for optimal protection.If you trust your dentist, then I advise following his treatment recommendations and do not ask him to do anything "that he wouldn't have done in his own mouth, or for his own family" (a good guideline).If you don't, and I suspect that may be going one here, why you're asking for more opinions, then I strongly suggest you get consultations with one or more dentists.  Choose the one whom you trust the most to do your actual treatment!However, understand that the diagnosis you receive from each dentist will certainly vary, and this is because dentists will vary in training, experience, personal philosophy and type of practice.  Sometimes there is not just one right answer, maybe several, just one may be better than an other.And, to keep things "honest", DO NOT SHARE THE TREATMENT PLAN GIVEN BY ONE DENTIST WITH ANOTHER.  You can certainly see the downside potential here, where one dentist knows you "are shopping", and all he has to do to get you to join his practice and get his treatment is to diagnose less than the previous dentist.Rather, don't even tell the dentist you are seeking a second opinion, just you would like his recommendations on "the best", or the "cheapest" or "the best looking" type of dentistry.  Again, you may get different recommendations based on which of those statements you make to your dentist when he/she asks you what he can do for you?Good luck!