Crown Lengthening...What's That?


This common procedure is used to allow more solid tooth structure to be available for rebuilding a diseased or broken down tooth. The process involves the removal of gum tissue and/or bone or both so that more tooth structure is accessible.

Why is it necessary?

Crown lengthening is utilized when a tooth needs to be rebuilt or restored, but there is not enough tooth is left to support a secure restoration.

This can happen when a filling gets too big, when the tooth fractures or breaks off near the gumline, a tooth that has lots of decay under a old filling or crown and so on. If you desire to keep the tooth and avoid more problems in the future, crown lengthening will allow the dentist to properly restore the tooth and give you a predictable result.

In situations where a person has a gummy smile - where the gums are as prevalent or more so than the teeth are the excess gums can be treated using crown lengthening.

What's Done

The tooth or teeth are numbed using local anesthesia. Although you may have one tooth that is the problem, crown lengthening typically includes adjacent teeth so that the gum tissues can have proper contour to avoid future problems. If only gum tissue is removed, it will generally take less time than if both gum tissue and bone are removed.

After the excess gum tissue and/or bone have been removed, they are reshaped. This results in more of the tooth or teeth being exposed. Depending on the method used to remove the gum and/or bone, your dentist may use a periodontal dressing, a type of bandage, to cover the area.

You may be given prescriptions for pain medication, possibly some antibiotics or a chlorhexidine (bacteria killing) mouth rinse. Your dentist will review how keep the area clean and may ask you to follow a somewhat soft diet. You can brush the teeth in the area that was treated, but you want to avoid the gums. You can remove excess food particles around the treated area with a gentle rinse, a toothpick or what ever device your dentist may recommend.

If the crown lengthening is done with laser therapy instead of the traditional surgical intervention, the healing will tend to be quicker and the procedure will have less swelling and discomfort as a rule. Not all lasers are appropriate for this procedure. Ask you dentist if laser therapy is available in your area and if it would be appropriate for your particular situation.

After treatment, what to do

For the first 48 hours, use ice on the affected area of your face to keep swelling down.

After the procedure, you will return to you dentist in a week to10 days to have any sutures removed if traditional surgery was done, and then return again a month to six weeks to evaluated healing. Your dentist will allow the gums to heal until they are stable before completing the tooth reconstruction process. In the interim time your dentist may rebuild the tooth and use a provisional restoration to protect the tooth and allow proper healing.

Possible Side Effects

Although the risks are few, the most common side affect of crown lengthening is prolonged bleeding or infection. Additionally, some patients will have increased sensitivity to temperature as when the roots of the teeth are exposed. This will go away when the roots are covered with a provisional restoration.

Since the damaged tooth has had crown lengthening it may look longer than the adjacent teeth. It can still be very healthy and probably will not be noticed by anyone other than the dentist as being different.

When To Call your Dentist

Contact your dentist if: