Crown LengtheningCrown lengthening is a common surgical procedure performed by periodontists to remove or reshape gum or bone tissue or both to expose more of a tooth. When only gum tissue is treated, the procedure is also known as a gingivectomy.

The main benefits of crown lengthening are:

  • It can enhance the appearance of a smile.
  • It enables restorative dental work to be carried out.
  • It can be used to treat gum disease (periodontitis).
  • It can help to prevent tooth decay.

Crown Lengthening to Improve Your Smile

Crown lengthening can address the problem of a gummy smile. An estimated 14 percent of women and seven percent of men have excessive gum exposure around their upper teeth when smiling. Crown lengthening removes gum and/or bone tissue to expose more tooth and allow the gums to retract to their correct position.

Crown lengthening can also correct an uneven smile line, which occurs when the gum tissue that arches over a tooth or teeth is lower than that of surrounding teeth. Even if teeth are properly aligned, this problem tends to create a jumbled look.

Crown Lengthening Ahead of a Crown or Filling

Crown lengthening can be carried out when not enough of a tooth protrudes from the gum to support a crown or filling. This problem can arise if a tooth breaks off at the gum line. It can also occur when a filling or crown falls out and there is underlying decay.

Crown Lengthening to Treat Gum Disease

If you have periodontal disease that has not responded to treatments such as antibiotics or root planning and scaling, crown lengthening can remove loose, diseased gum tissue to eliminate the problem of pockets between gums and teeth.

How Crown Lengthening Can Improve Oral Hygiene

There is a further benefit of crown lengthening if you are particularly prone to developing cavities. Removing excess gum tissue makes it easier to clean your teeth to lessen the risk of tooth decay.

The Crown Lengthening Procedure

You may need to have your teeth professionally cleaned before your crown lengthening procedure to remove any plaque and debris that may have accumulated around your gumline.

Crown lengthening is done with a local anesthetic. How long the procedure takes depends on the number of teeth requiring treatment. Even if only a single tooth is involved, crown lengthening generally includes adjacent teeth. Crown lengthening usually takes about an hour. If bone is removed as well as soft tissue, the procedure will take longer.

Your periodontist will make incisions to enable gum tissue to be pulled away from the teeth. This exposes tooth roots and supporting bone. In some cases, removing a small amount of tissue will be sufficient to place a crown or filling. In most cases, though, your periodontist will need to remove some of the bone surrounding the roots of the teeth.

Once enough of the tooth has been exposed, the surgical site is washed with sterile salt water and the gum tissue stitched back together. A bandage may be applied over the sutures. If your periodontist didn’t use dissolvable stitches, the sutures will be taken out seven to ten days after the procedure. This will be followed by a further appointment four to six weeks later to make sure your gums are healing properly.

You will typically be prescribed pain relief and a special mouthwash after a crown lengthening. Your periodontist will recommend you follow a soft-food diet for a while. You can brush the teeth near the stitches but should avoid the gums. You should be able to remove food debris with a toothpick. For the first few hours after surgery, you can use an ice pack on your face to reduce swelling.

If your crown lengthening was performed ahead of placing a permanent crown, it will take about three months before your gums have healed sufficiently for the crown to be fitted. Your gums can shrink as they heal. If you don't wait long enough, the edges of the crown could show.

Are There Any Risks with Crown Lengthening?

Following crown lengthening, there may be some bleeding for a time and there is a risk of infection. This is the case after any type of surgery. If you follow your periodontist’s instructions on how to look after yourself after your crown lengthening procedure, the risk of complications is minimal.

Some people find that their teeth become temporarily sensitive to hot and cold foods and drinks after crown lengthening. This is because the tooth roots have been exposed. This sensitivity disappears with time, or when a crown is placed on the tooth.

Removing bone from around a tooth can make it feel looser. If the tooth is ever lost, it could be harder to replace it with a dental implant. Your periodontist will talk about these possibilities with you.

After crown lengthening, a tooth can appear longer than those surrounding it. While this is precisely the intention of crown lengthening, the new look can sometimes surprise patients.

Most patients believe that the many benefits of crown lengthening far outweigh any potential minor complications. An experienced periodontal specialist will have the expertise to minimize any risks of a crown lengthening procedure and be able to handle potential problems.

A Routine Procedure to Boost Dental Health or Improve Your Smile

In the hands of a skilled periodontist, crown lengthening is a routine procedure, and you can expect it to go smoothly, improving your oral health or giving you an enhanced smile.

According to the American Academy of Periodontology (AAP), crown lengthening has two key benefits: enhancing the appearance of the teeth or preparing teeth for further dental or periodontal work.

If your crown lengthening procedure is carried out to save a tooth, your insurance should pick up some of the costs. If the procedure is for cosmetic purposes, it won’t be covered by insurance. However, a good periodontal practice will offer affordable payment plans.

If you are considering crown lengthening, bear in mind that the only surgeons recognized by the American Dental Association (ADA) are maxillofacial (jaw and face) and oral surgeons and periodontists.