A dental pontic is one of the key components of a dental bridge, which is a fixed restorative procedure to replace missing teeth. However, the pontic alone is not a complete procedure because it requires a connected dental abutment for the entire bridge to hold. Without the abutment, it wouldn't even stay in the mouth.
Table of Contents:
What is a dental pontic?
The dental pontic is the fake tooth or the dummy tooth that is a part of your bridge. This is distinctly different than the dental abutment which is the part of the bridge which is glued onto your natural tooth.
A tooth bridge consists of two components:
Abutment - The part that covers over an actual tooth.
Pontic - The part that is the replacement for the missing tooth and empty space.
Typically, the abutments are at the end while the pontic is in the middle. The only exception would be a cantilever which can have a pontic at the end of the prosthesis.
What it looks like
The pontic will look just like a regular dental crown. You most likely won't be able to tell which one is the pontic and which one is the abutment.
Nonetheless, below are photos which show what an entire bridge looks like:
The two photos above show what the dental bridge looks like on the model and off the model. When it is taken off the model, you can tell that the middle crown is the pontic.
The abutments look hollow underneath.
The pontic is solid underneath.
That is basically what they look like and how you can distinguish them.
What it's made of
There are three types of material that the pontic can be made of.
Porcelain fused to metal. The traditional bridge used to be made of PFM which was prior to the advent of all ceramic. This type has a metal substructure and procelain that is glazed over it for cosmetics.
Full cast metal. It could be pure metal where it looks completely black. Alternatively, you can also have it as full gold which is highly biocompatible in the mouth.
All ceramic. Otherwise known as all porcelain, it is considered metal-less. The material choices can be pure zirconia or lithium disilicate (emax).
Essentially, the material choices for it is the same as any dental crown.
When is it necessary?
The purpose of a dental pontic is to replace a missing tooth. However, if you're not missing a tooth then it is unnecessary. Basically, if there is nothing to replace then it is unneeded.
Conditions where you may be missing a tooth:
Tooth decay. If you don't take care of your teeth or take care of cavities while they're small, it can get big enough to destroy your tooth.
Dental abscess. A serious infection can render a tooth non-restorable thus forcing you to get it extracted. If you think you have an abscess, try to get it treated as soon as possible.
Accident or injury. Front teeth are the most prone to getting knocked out of the mouth. If you wanted evidence, just ask a hockey player why they're missing so many teeth!
Congenitally missing. You could've drawn the short straw genetically and a tooth may have never grew in. The condition is called hypodontia where you have less teeth than the average person.
Regardless of why you're missing a tooth, it does make you eligible to consider getting this treatment done.
Pros and Cons
Pros:
Replaces missing tooth.
Less expensive than an implant.
Takes less time and appointments than an implant.
Cons:
Requires preparing adjacent teeth for a bridge.
Cannot floss through it.
Procedure details
The pontic is not a standalone dental procedure because it is a part of the bridge procedure. For all of the steps involved, please check out our complete comprehensive guide for dental bridges.
Yes, you will most likely need to be numb for the entire procedure since the adjacent teeth will need to be prepared (shaved down).
How much does it cost?
The average cost of a dental pontic is $1287.64 without insurance. However, you should be aware that it is once again, a part of the bridge procedure so you should take that into account for the total cost.
The cost may range from as low as $1000 to as high as $1675 but it all depends on the cost of living in your neighborhood. Although it can cost even more than the high end range if you go to a super high end dental practice that caters to celebrities.
These numbers were from the ADA survey of dental fees.
Cost with insurance
Dental insurance will usually cover about 50% of the procedure so each pontic may cost $643.82. That would be your copayment or out of pocket expense.
However, it may cost more or less depending on your coverage level with your particular insurance plan. We've seen some plans with 80% coverage and some with 0% coverage.
Note: You should also be aware that some insurances have a missing tooth clause, which can deny you benefits. If you were missing that tooth before you enrolled in the insurance plan, you will not have coverage for this procedure!
Outlook
The pontics can last a very long time if you take care of them properly. Research shows that the 10 year survival rate is approximately 84% for a bridge along with its pontic.
A major factor in how long it can last depends on how many units are in the bridge:
Shorter bridges tended to have a higher survival rate.
Longer bridges with 5 or more units had a lower survival rate.
Aftercare
The dental pontic is immune to cavities but their neighbors the dental abutments are not. The abutments do have natural tooth underneath it which can fall prey to tooth decay. If the abutment fails, the pontic will go with it since they go hand in hand.
What we're trying to say is that you will still need to brush it even though it is a fake tooth. However you won't be able to floss it like your other teeth since the abutments and pontics are joined together. You will need a different type of floss in order to clean under it.
Floss threader. You thread your usual floss through the threader like threading a needle. Then you can insert the stiff threader underneath of the pontic.
Super floss. Similar to regular floss but one end is extra stiff which lets you thread it through the pontic.
Water flosser. A device which shoots pressurized water to flush out plaque and food.
Our personal favorite is the super floss since it is very convenient. However, if you're lacking in manual dexterity, the water floss is a viable alternative.
