What is Crown Lengthening and When Do I Need It?

 If you have been told by your dentist that in order to complete your crown or filling you need crown lengthening, you may have questions as to what it is and why you need it. This quick article will address those questions.

Crown lengthening is a procedure that is designed to be either what in dental terms is known as functional or esthetic.

Functional crown lengthening is a surgical procedure used to create space between the end of the crown or filling and the bone holding your tooth in the mouth. This surgical procedure can be performed with dental instruments or dental lasers which make it fast and painless. This space is necessary for the gums to ‘breathe’ and be healthy. This space, which is about 2-3millimeters in length, can’t have dental filling material or the tooth crown placed into it or the body will react to it. The body may ‘reject’ the dental filling or crown by the gums becoming inflamed, swollen, red, and start to bleed. Functional crown lengthening is also needed when the tooth is broken down or has cavities in it or near the gum line. There must be enough tooth left above the gums to put a crown or dental filling into the tooth. If the tooth is broken down, functional crown lengthening is a surgical procedure that will remove enough of the bone and gum to allow for a long-lasting tooth crown or filling.

Esthetic crown lengthening is a surgical procedure used to reshape the gums or remove excess tissue to correct a gummy smile. When you grow, the jaw can grow and the gums can move around the teeth unevenly. This can lead to some of the gums being asymmetrical and look uneven. Esthetic crown lengthening often uses a dental laser to shape the gum tissue around the teeth in a non-invasive manner that makes them look even. Esthetic crown lengthening is also used to remove excess gum in cases when patients smile and show too much gum (figure 1). Lasers can be used to reduce the gum tissue and make the teeth look longer so more teeth show when you smile (figure 2). Esthetic crown lengthening is also used before someone gets veneers or crowns so these restorations appear more cosmetic and natural.

Crown lengthening is a very common procedure and is usually quick and painless. The procedure can be performed with local anesthesia and when using a laser, often does not require stitches. In cases of functional crown lengthening, the dentist can put a temporary crown on the teeth and then the periodontist will use that as a marker for how much bone and/or gum tissue needs to be removed to make the tooth crown long-lasting. In cases of esthetic crown lengthening, a wax model or digital model can be used to guide the periodontist on how to shape the gums or correct the gummy smile. In many instances the time of the procedure can be 30-60 minutes and the healing time is usually a few days. Over the counter pain relief is usually sufficient to control any discomfort and the periodontist may give you a prescribed mouth rinse to keep the area clean.  In some instances, glue stitches can be used, or a surgical dressing can be applied.  You may feel tooth sensitivity after the procedure and a desensitizing gel or toothpaste can be used.

The gums usually take 4-6 weeks to fully heal before the tooth crowns, veneers, or dental fillings can be done. If you are not getting any dental restoration on the teeth and the procedure was performed to correct a gummy smile or reshape the gums, full healing should be around 2-3 months for the gums to fully settle into position.  Crown lengthening is one of the quickest and painless surgical procedures that can be performed with great results and success. Contact your periodontist today to find out more about this treatment.