What Is Crown Lengthening?

Imagine this: your dentist has examined your teeth and determined you need a crown. But what if there is not enough tooth for a crown? This is when a crown lengthening procedure is recommended to support a dental crown or tooth bridge. There are a few reasons why you may not have enough tooth for a recommended treatment:

• Your tooth may have broken off at the gumline.
• The tooth structure isn’t strong enough for restoration.
• A crown or filling falls off and there is decay underneath.

According to the American Academy of Periodontology (AAP) a dental crown lengthening procedure can be done to improve a “gummy smile.” This term may be used when teeth appear short, because of excess gum tissue. It’s important to note that every smile is different, and just because it may look like you have short teeth, they’re likely the proper length. However, a smile you feel great about is important, and you and your dentist can discuss if crown lengthening is an option for you.

A periodontist will review your medical history and X-rays before setting a date for the procedure. You may also get a professional cleaning done by a dental hygienist beforehand to decrease risk of infection.

If the goal for the procedure is to reveal enough tooth for a crown, a temporary one may be placed to protect the tooth. This allows the periodontist to see how much soft tissue or bone to remove. After three months of healing a final crown will be placed to fit the lengthened tooth.

The amount of time the surgery takes depends on the number of teeth that need treatment, and if both bone and soft tissue are removed. One tooth may need to be fixed, but neighboring teeth are often also included in the treatment so the tissues reshape gradually. This is normally done using local anesthesia combined with a sedative.

• Step 1: Small incisions are made in the gum to make a tiny flap of tissue to be lifted out of the way.
• Step 2: The underlying bone tissue is reshaped to properly support the gum tissue in its improved position.
• Step 3: The tissue flap is then repositioned and sutured into place, following the new contours of the gumline.
• Step 4: The surgical area and gum tissue will be stitched together. Sometimes a surgical dressing may be placed over the stitches.

According to Medical News Today, you can take anti-inflammatory medication and use a cold compress to help with any pain or swelling. While you recover stick to soft foods and rinse your mouth after meals. During these first few days of healing your gums will continue to shrink as the swelling comes down. If the back of your mouth underwent the procedure full healing may take 6-12 weeks, while your expected healing time for front of the mouth could take 3-6 months.

The two main complications, bleeding and infection, can occur after any type of surgery. If you experience any symptoms beyond the expected, such as bleeding that doesn’t stop, signs of infection, or pain that doesn’t lessen, call your periodontist.

Specific to crown lengthening surgery you should watch for:

• Sensitivity to hot and cold: This should go away with time, or when a crown is placed.
• Appearance: The affected tooth may look longer than the teeth next to it after the tissue and bone removal.
• Looseness: It’s a possibility that removing bone from around a tooth can make it feel looser.

Everyone deserves a bright, confident smile. Your dentist can help you decide on the right course of treatment, so your smile is one you love to show off.

This article is intended to promote understanding of and knowledge about general oral health topics. It is not intended to be a substitute for professional advice, diagnosis or treatment. Always seek the advice of your dentist or other qualified healthcare provider with any questions you may have regarding a medical condition or treatment.