Crown lengthening is generally performed to improve the health of the gum tissue or to prepare the mouth for restorative procedures or cosmetic procedures such as Crowns, Veneers, or Cosmetic Fillings. There are some circumstances when cavities or “decay” of teeth penetrates deep below the gum line and this procedure, crown lengthening, helps to expose the full extent of the cavity so it can then be treated with restorations like fillings or crowns. In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue.  Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue.  This treatment can be performed on a single tooth, many teeth, or the entire gum line, exposing an aesthetically pleasing smile. 

Reasons for crown lengthening

Crown lengthening is a versatile and common procedure that has many effective uses and benefits.  The vast majority of patients who have undergone this type of surgery are highly delighted with the results.

Here are some of the most common reasons for crown lengthening:

• Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay.  Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth. Also, as briefly discussed above, “decay” or a cavity can destroy part of a tooth and extend past below the gum line, where your dentist cannot reach because the gums are in the “way.” Crown lengthening allows to expose the entire cavity so that your Dentist can proceed with placing a filling free of voids or remaining decay. Of course, your Periodontist would have to make sure your tooth is a candidate for this procedure. 
• Cosmetic uses – Extra gum tissue can make teeth look unnaturally short, square shaped, and can also increase susceptibility to periodontal infections.  Removing excess gum tissue can restore a balanced, healthy look and improve the aesthetic appearance of the smile. 
• Dental crowns – Sometimes, existing crowns are fabricated in close proximity to the underlying bone surrounding a tooth. Your gums naturally become irritated by this new material being so close to the bone, appearing red and bleeding very easily at first, followed by leading to bone loss. This is referred to as biologic width violation. The advantage of crown lengthening in this case is that it can provide more space between the supporting jawbone and dental crown. This procedure, in turn prevents an existing crown or a new crown from damaging gum tissues and bone once it is in place. Your Periodontist can help with diagnosing biologic width violation and seeing if your tooth is a candidate for crown lengthening.

What does crown lengthening involve?

Crown lengthening is normally performed under local anesthetic.  The amount of time this procedure takes will largely depend on how many teeth are involved and whether a small amount of bone needs to be removed along with the soft tissue.  Depending on your Dentist, a temporary crown (provisional crown) may be placed on the tooth that requires the crown lengthening.  This temporary crown will be removed prior to the procedure and replaced immediately afterwards. 

The crown lengthening procedure involves making a series of small incisions around the soft tissue in order to separate the gums away from the teeth.  Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping.  Separating the gums provides your dentist with access to the roots of the teeth and the underlying bone.

In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown.  In other cases, your periodontist will also need to remove a small amount of bone from around the teeth.  The bone is usually removed using a combination of special hand instruments, and rotary instruments.  The rotary instruments roughly resemble the drill that is used in cavity treatment.

The teeth will look noticeably longer immediately after surgery because the gums will have been repositioned. 

Your dentist will secure the surgical site using an intraoral (periodontal) bandage which serves to prevent infection.  Prescriptions may be provided for pain medication, and a chlorhexidine (antimicrobial) mouth rinse may be given to help reduce any bacteria attempting to re-colonize. 

The surgical site will be completely healed in approximately two to three months. 

If you have any questions about crown lengthening, please contact our office.