Crown lengthening is generally performed in order to improve the health of the gum tissue, or to prepare the mouth for restorative or cosmetic procedures.  In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue.  Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue.  This treatment can be performed on a single tooth, many teeth or the entire gum line, to expose a pleasant, esthetically pleasing smile.

Reasons for crown lengthening

Crown lengthening is a versatile and common procedure that has many effective uses and benefits.  The vast majority of patients who have undergone this type of surgery are highly delighted with the results.

Here are some of the most common reasons for crown lengthening:

• Restoration of damaged teeth – Periodontal disease, decay and trauma can cause severe damage to the teeth.  Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth so that the dentist can get access to healthy tooth structure before placing a final crown.
  
  
• Cosmetic benefits – Extra gum tissue can make teeth look unnaturally short, and also increase susceptibility to periodontal infections.  Removing excess gum tissue can restore a balanced, healthy look and thus improve the esthetic appearance of the smile.
  
  
• Dental crowns – Crown lengthening serves to provide more space between the supporting jawbone and dental crown.  This prevents the new crown from damaging gum tissues and bone once it is in place.

What does crown lengthening involve?

Crown lengthening is normally performed under local anesthetic.  The amount of time this procedure takes will largely depend on how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue. 

The Periodontist will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth.  Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping.  Separating the gums provides the Periodontist with access to the roots of the teeth and the underlying bone.

In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown.  In other cases, the Periodontist will also need to remove a small amount of bone from around the teeth. 

When the Periodontist is satisfied the teeth have sufficient exposure, the gum tissue will be sutured with small stitches.  These stitches can actually be placed on the inside (tongue side) so that the gums are barely noticeable that a surgical procedure was completed (other than that the smile is prettier). The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned.

Prescriptions may be provided for their anti-inflammatory affect which can prevent pain, and a chlorhexidine (antimicrobial) mouth rinse may be given to help reduce any bacteria from adhering to the surgical site.  This will be completely healed in approximately four to six weeks.

If you have any questions about crown lengthening, please ask your Periodontist.