Crown lengthening is a common dental procedure designed to expose more of a tooth’s structure. This treatment helps address various dental concerns, ranging from preparing a tooth for a restoration to improving the appearance of a smile. It is a precise procedure performed by a dental professional.
Defining Crown Lengthening
Crown lengthening is a surgical procedure that involves adjusting the gum tissue, and sometimes the underlying bone, around a tooth to expose more of its surface. The primary goal is to lengthen the “clinical crown,” which is the visible portion of the tooth that extends above the gumline.
A fundamental concept in this procedure is “biological width,” which refers to the specific distance maintained between the gum tissue and the underlying bone around a tooth. Respecting this biological width during crown lengthening is important for maintaining gum health and preventing inflammation.
Reasons for Crown Lengthening
Dental professionals recommend crown lengthening for both functional and aesthetic purposes. Functionally, it provides sufficient tooth structure necessary for dental restorations. For instance, if decay or a fracture extends below the gumline, this procedure allows the dentist access to the damaged area for effective treatment, such as placing a crown or large filling.
Aesthetically, crown lengthening can address a “gummy smile,” where excess gum tissue makes teeth appear shorter. Removing this excess tissue reveals more of the tooth, creating a more balanced smile. It can also correct an uneven gumline for a more harmonious appearance.
The Procedure Steps
The crown lengthening procedure begins with an initial consultation, where the dental professional reviews the patient’s medical history and takes X-rays to evaluate the gum and bone structure. Local anesthesia is administered to numb the treatment area, ensuring comfort throughout the procedure. In some instances, sedation options may also be available.
The next step involves carefully reshaping the gum tissue. Precise incisions are made to gently separate the gum from the teeth, allowing the periodontist to access the underlying structures. In certain cases, a small amount of bone may also be recontoured or removed. This bone removal is performed when necessary to establish the correct biological width and expose more tooth structure, though it is not always required for every procedure.
Once the desired amount of tooth structure is exposed, the gum tissue is carefully repositioned and secured with sutures. A protective periodontal dressing may be applied over the surgical site for initial healing and comfort. The entire procedure typically takes less than an hour to complete, though the duration can vary depending on the number of teeth involved and the extent of tissue removal.
Post-Procedure Care and Healing
Following a crown lengthening procedure, patients can expect some mild swelling, discomfort, and slight bleeding in the treated area. These are normal responses and usually subside within the first few days. Managing pain and swelling often involves taking over-the-counter pain relievers and applying cold compresses to the outside of the face for the first 24 to 48 hours. Elevating the head while sleeping can also help reduce swelling.
Dietary adjustments are important during the initial healing period. Patients are typically advised to consume soft, non-irritating foods and avoid anything hard, sticky, or overly hot or cold. Maintaining oral hygiene is also important, though gentle care is required. Patients should brush carefully around the surgical site, avoiding direct contact with the healing gums for the first few days. Prescribed antiseptic mouth rinses may be recommended to keep the area clean and reduce the risk of infection, while vigorous rinsing should be avoided.
Strenuous physical activity should be avoided for a few days following the procedure to prevent increased blood flow and swelling. Follow-up appointments are scheduled to monitor healing progress and remove sutures, typically within one to two weeks. While initial recovery occurs within days to weeks, the gum tissue can take several months to fully mature and stabilize. Temporary tooth sensitivity to temperature changes is also common due to newly exposed tooth surfaces and diminishes as healing progresses.