Guide to Crown Lengthening

If you have a cavity or are getting a crown, you might also find out you’ll need an additional procedure called a crown lengthening. Patients looking for a pleasing smile often turn to this procedure, which reduces the amount of gum tissue that shows above the top teeth. This can provide an esthetically pleasing outcome.

What’s crown lengthening, and why is it necessary? In this guide, we’ll walk you through the procedure and offer some reasons one simple treatment might evolve into a surgical one. We’ll also cover what else you can expect during and after a crown lengthening procedure.

[Related: Gum Bleaching, Whitening and Lightening: What You Need to Know]

What Is Crown Lengthening?

During a crown lengthening procedure, a periodontist reshapes the gums at the base of the desired tooth to expose additional tooth surface. If necessary, the procedure can adjust the bone level to extend the height or size of the tooth portion  that’s visible above the gumline. That way, your new restoration has enough tooth structure to hold it in place.

Your gums need at least 2 mm of tooth surface area to bond with to prevent trapped foods and other problems. If part of a tooth is missing or decay is too deep, periodontists use crown lengthening to recreate the required amount of exposed tooth so that restorative dental procedures won’t weaken or fall off.

[Related: Recurring Swollen Gums? Here’s What to Do]

Conditions That Require Crown Lengthening

A number of dental conditions need restorations with crown lengthening.

Here are some common conditions: 

• A short tooth
• Severe tooth decay below the gumline
• A tooth that’s fractured and broken off beneath the gumline

A crown lengthening procedure can reduce the bone level and gum tissue so that the periodontist has better access to your tooth.

When a tooth breaks or decay is severe, the tooth’s remaining healthy area shrinks. This can affect the potential for a successful tooth restoration. 

With crown lengthening, the periodontist exposes more of the tooth’s surface. The longer tooth surface acts as an anchor for future restorative work, such as crowns or veneers. 

[Related: Periodontal Disease and Cardiovascular Health]

Crown Lengthening Surgical Process

Crown lengthening is a very common surgical procedure, and it usually takes one hour or less. Your periodontist administers a local anesthetic, which they can combine with sedation for patients who request it. They then use specialized surgical instruments to recontour both the gum tissue and the underlying bone around the tooth that’ll take a crown. 

The goal is to lengthen the appropriate teeth and to create greater symmetry at the gumline. Your periodontist only treats the tissue in the immediate area surrounding the tooth, and there’s no risk of damage to the neighboring teeth.

Postoperative Care

Most patients don’t need any special postoperative care after a crown lengthening procedure. They can manage most slight discomfort with ibuprofen (like Advil) or acetaminophen (like Tylenol).

Fortunately, the crown lengthening recovery time is fairly short. 

Patients can return to their daily routine and begin eating soft foods after surgery. Complete gum tissue recovery typically takes 3 to 4 weeks.

Before you get a permanent restoration, you need to wait four to six weeks after the procedure. Then, you get the go-ahead from your periodontist. Crown lengthening is a simple procedure that goes a long way to ensure a healthy, long-lasting crown restoration.

[Related: How to Properly Treat Your Receding Gums]

Crown Lengthening FAQ

Should I expect bleeding after crown lengthening?

Slight bleeding after crown lengthening is common. If bleeding persists, dab the area with a small moist cloth and apply pressure for about 15 minutes. Bleeding should stop after a few hours, but if it doesn’t, contact your periodontist for a follow-up.

Does the gum grow back after crown lengthening?

Your periodontist has to remove bone for a successful crown lengthening treatment. If they remove only the gum, the tissue might simply grow back in about eight weeks, which prevents lasting results.

What is the average crown lengthening cost?

The cost of a crown lengthening procedure varies depending on how many teeth need work. In general, the procedure costs from $50 to $300 for one tooth, and it could cost $2,000 or more for multiple teeth. 

Does insurance cover crown lengthening?

Your health insurance may cover the cost of crown lengthening unless the procedure is purely cosmetic. Speak with your insurance provider and periodontist to find out for certain.

Are there alternatives to crown lengthening?

To deal with excess gum tissue, crown lengthening remains the best treatment option. However, alternatives to crown lengthening are available, such as deep margin elevation, orthodontic intrusion and bridge retention surgery.

Find Out More at Cascadia Dental Specialists

To find out more about crown lengthening, learn about other periodontal services or request an appointment with one of our dental specialists, contact Cascadia Dental Specialists today!

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