Crown Lengthening

Why would I need crown lengthening?

Crown lengthening is usually performed to prepare a tooth or teeth for a restoration such as a crown or a bridge or to correct a “gummy smile” for esthetics. 

Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration may be deep below the gum tissue.  This can make it impossible for the dentist to get a good seal of the restoration on the tooth.  There can then be a gap which then lets bacteria get under the crown or bridge, leading to decay and the tooth rotting from the inside out.  There may also not be enough tooth left for the crown or bridge to hold on to.  In addition, the edge of the restoration can also be too close to the bone if it’s deep under the gums.  This can cause irritation to the bone and lead to bone loss.

Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.

A “gummy smile” is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile. The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. Crown lengthening can be performed on a single tooth, many teeth, or the entire gum line.

Before and After Photos of Esthetic Crown Lengthening:

Pre-surgery in the left photo, 8 weeks post-surgery in the right photo

About the Crown Lengthening Procedure

The procedure is usually performed under local anesthetic with or without sedation and involves a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it will probably be necessary to adjust the surrounding teeth to enable a more even reshaping. A small amount of bone is removed to let the gum tissue settle at its new, lower level.  This is necessary because the gum tissue takes its cue for how high to grow from the underlying bone.  If only the gum is removed and not the bone, the gum tissue will grow right back after about 8 weeks, negating the purpose of the crown lengthening.  The bone removal, typically only 1-3mm, is required for a good, lasting result.

When Drs. Morse, Cwiklinski or Achille are satisfied that the teeth have sufficient exposure and the procedure is completed, sutures and a protective bandage are placed to help secure the new gum-to-tooth relationship. Your teeth will look noticeably longer immediately after surgery because the gums have now been repositioned. You will need to be seen in two weeks to remove the sutures and evaluate your healing. The surgical site should be completely healed in approximately 2-3 months following the procedure.  If crowns or veneers are planned after the crown lengthening, your restorative dentist will see you after that 2-3 month check-up to begin that treatment.