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What is Crown Lengthening?

This is a surgical dental procedure involving the removal of gum tissue and bone to expose more tooth surface area.

Why is Crown Lengthening performed?

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 (restoration) 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.
  • A tooth has decay below the gum line.

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

What are the steps before Crown lengthening surgery?

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

How is Crown Lengthening performed?

The crown lengthening procedure is performed under local anesthesia. The periodontist will cut and peel 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.

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.

 Before Crown Lengthening

Before Crown Lengthening

 Before Crown Lengthening

Before Crown Lengthening

 After Crown Lengthening

After Crown Lengthening

 After Crown Lengthening

After Crown Lengthening

You will be given prescriptions for a pain reliever and a mouth rinse. Your dentist will ask you to follow a somewhat soft diet. You can brush the teeth near the stitches, but avoid the gums. Remove food particles with a toothpick or a water irrigator.

What are the steps after Crown Lengthening surgery?

The periodontist will prescribe pain medication and a chlorhexidine mouth rinse. An ice pack may be placed against the face to reduce swelling. The patient will be instructed in post-surgery care, and scheduled to return in 7 to 10 days for follow-up. The gums will be allowed to fully heal for 4-8 weeks then the tooth is prepared for the restoration or final crown.