Crown Lengthening

Our doctors use periodontal procedures not only to advance the health of your gums and teeth but also to enhance the appearance of your smile.

You may feel that your smile is "gummy" — that your gums seem too large or your teeth seem too short. At times, the teeth are actually small and can be brought into proper proportion through cosmetic techniques such as dental bonding. However, often the teeth are of normal length but the gum tissue extends further than it should, covering the base of the teeth and making them look too short. In this case, we are able to perform a procedure called crown lengthening.

Through the crown lengthening procedure, the excess gum and bone tissue is reshaped in order to expose more of the natural tooth. Crown lengthening can be performed to just one tooth to even your gum line or to a number of teeth to allow your smile to look broader and more pleasing.

Sometimes our doctors may recommend crown lengthening to enable us to perform a cosmetic or restorative dental procedure. If your tooth is decayed, broken beneath the gum line or has too little structure left to place a crown or bridge, the crown lengthening procedure allows the doctor to expose more of your tooth so that the restoration can proceed.

While most people think of a gummy smile as purely an aesthetic problem, the crown lengthening procedure not only improves the appearance of your smile and boosts your self-confidence, it also aids in your ability to chew food and to speak properly.

There are various reasons our doctors may recommend that you have a crown lengthening procedure.

If your smile looks "gummy", as though your gums are too large or too long, crown lengthening can be performed to just one tooth to even your gum line or to a number of teeth to make your smile to look broader and more pleasing.

Our doctors may also recommend crown lengthening to allow them to perform a cosmetic or restorative dental procedure. If your tooth is decayed, broken beneath the gum line or has too little structure left to place a crown or bridge, the crown lengthening procedure allows your doctor to expose more of the tooth so that the restoration can be accomplished.

Prior to the crown lengthening procedure, you may receive a tooth cleaning. And, if the procedure is being performed to permit placement of a crown, the doctor may place a temporary crown on the tooth to protect it. This is helpful because having the tooth already prepared for the crown makes is easier to see the amount of soft tissue and/or bone that needs to be removed.

The crown lengthening procedure is done using a local anesthetic. The amount of time it takes will depend upon how many teeth are involved and whether it requires removal of the gum tissue alone or the bone, as well.

The doctor will make incisions and flap the gum away from your tooth, giving access to the tooth's root and the bone that surrounds it. In some cases, after the incisions are made enough gum tissue is able to be removed to enhance the length of the tooth or supply sufficient tooth structure for the placement of a crown or filling.

Usually it is also necessary for the doctor to remove some bone from around the root of the tooth. If this is needed, the bone will be removed using a combination of small hand instruments and rotary instruments like those used to prepare a tooth for a filling.

After enough of the tooth structure is revealed, the doctor will wash the surgical site with sterile salt water and the flaps will be sutured closed. Your teeth will appear longer immediately because the gum tissue has been removed, actually shortening the gum and giving the tooth a longer appearance. Depending upon the case, the doctor may place a periodontal dressing, an intraoral bandage, over the surgical site.

If you are having crown lengthening in preparation for crown placement, your temporary crown will be removed prior to the procedure and replaced following it. After a healing period of approximately six weeks, the doctor will prepare your tooth with a new temporary crown and, as long as it remains free of infection, your natural-looking permanent crown will be placed shortly thereafter.

It's necessary to allow this healing time because if your new temporary or permanent crown is placed any sooner, healing may not be complete. In this instance, after crown placement, the gums may shrink as they heal further and the top edges (or margins) of the crown closest to the gum may show.

Whatever the purpose of your crown lengthening treatment, following the procedure, you will receive prescriptions for pain medication, antibiotics, and a chlorhexidine mouth rinse. The doctor will go over oral hygiene instructions with you and advise you about the diet you should follow as the surgical site heals. You should continue to brush the teeth in the area of the surgery but be careful to avoid the gums in order to protect them. A toothpick or water irrigator can be used to gently remove food particles from the teeth.

There is some swelling the first couple days after the procedure which may be controlled with an ice compress to the face. Seven to ten days following the procedure, you'll return to our office to have your sutures removed and then you'll come back four to six weeks later for your follow-up visit.

If you're unhappy with a gummy smile or if you would like to learn more about how the crown lengthening procedure can aid in the treatment of teeth whose structure is compromised because they are broken or decayed, please give our office a call.