Crown Lengthening

Crown lengthening is a surgical dental procedure involving the removal of gum tissue and bone to expose more tooth surface area. Crown lengthening is often performed when a tooth needs to be fixed, but not enough of the tooth protrudes above the gum to support a filling or crown. This can happen when:

• A tooth cracks off at the gum line.
• A crown or filling falls out of a tooth and there is tooth decay underneath.

Crown lengthening can also be used in cosmetic dentistry to fix a “gummy smile”, when the patient has a lot of gum tissue around their upper teeth. Excess gum tissue is removed to create a more aesthetically pleasing appearance.

Before the surgery, the patient may require professional teeth cleaning. If the patient needs a crown, the surgeon may place a temporary crown before the crown lengthening procedure. The temporary crown protects the tooth and allows the surgeon to gage how much soft tissue or bone to remove.

Crown lengthening procedures are usually performed under local anesthesia. The periodontist will cut and pull the gums away from the teeth to expose the roots of the teeth and the surrounding bone. The surgeon will then remove gum tissue and sometimes bone from around the roots of the teeth. Bone is removed using a combination of hand instruments and rotary instruments. Once enough of the tooth has been exposed, the area will be irrigated with sterile salt water and the gums will be stitched together. The periodontist may cover the surgical site with a dressing called an intra oral bandage.

Even if only one tooth needs crown lengthening, the surgeon may include neighboring teeth so that the gum tissues are evenly reshaped. Post surgery, the teeth will appear elongated because the gums are now shorter then before the surgery.

After the surgery, the dentist will prescribe pain medication and a chlorhexidine mouth rinse. An ice pack placed against the face will help reduce swelling. The patient will be instructed in post surgery care, and scheduled to return in 7 to 10 days for stitch removal. The gums will be allowed to fully heal for two to three months before the tooth is prepared for the final crown.