What is a crown lengthening procedure?

Crowns are tooth-shaped caps that fit over a natural tooth for aesthetic or structural reasons. A crown may be recommended when a tooth is cracked, broken, or misshapen. A crown can also be used to complete dental procedures, such as bridges, root canals, and dental implants. Crowns must be able to firmly affix to an existing tooth.

Crown lengthening can help. Dental surgeons perform crown lengthening by recontouring gum tissue, and sometimes bone, to expose more of a tooth’s surface for a crown. It’s a common procedure and often takes less than an hour to complete.

The purpose of a crown lengthening procedure

Crown lengthening can be necessary if there isn’t enough of the tooth in place to hold the crown on its own. Teeth that are broken or affected by tooth decay may prohibit a crown from firmly attaching.

Crown lengthening reduces gum tissue and shaves down bone when necessary so more of the tooth is above the gum’s surface. A properly fitted crown allows for better oral hygiene and comfort.

Some people seek crown lengthening to alter a “gummy smile,” in which the gums are visible above the teeth when smiling.

How to prepare for a crown lengthening

Your dental surgeon may fit you with a temporary crown until you can have your procedure. The temporary crown can protect your tooth in the interim and can make the fitting of your new crown easier.

Before your surgery, you will meet with the periodontist to give a medical history and for them to view your X-rays. During this appointment, you should talk to your surgeon about any medications you take. They’ll let you know if you need to discontinue any of them for the procedure.

What happens during a crown lengthening procedure

Your periodontist will perform the crown lengthening during an outpatient procedure. This means you can go home afterward. The time the procedure takes varies depending on the number of teeth that need the procedure and if both soft tissue and bone need to be removed. If you have a temporary crown on any of your neighboring teeth, your periodontist may remove them before the procedure and replace them afterward.

Most people receive local anesthesia and may receive a sedative as well. The periodontist cuts the gums to pull them away from the teeth, exposing the roots and bone. In some cases, only the gum tissue needs to be removed. The surgeon then washes the surgical area with salt water before suturing. They suture the gums back together, sometimes placing a bandage over the area for additional protection.

You will feel some pain after the local anesthesia wears off, so your surgeon will prescribe you pain relievers and a specialized mouth rinse to help your gums heal.

Possible risks

There is some risk of infection with crown lengthening, but no more than with other surgical procedures. You should follow all postoperative care instructions to help prevent infection. Contact your dental office with any questions during your recovery.

You might experience bleeding at the surgical site after the procedure, and your teeth may be sensitive to hot and cold temperatures. The sensitivity will ease with time. Your tooth might look longer than the neighboring teeth, and if bone was removed, the tooth may feel looser. If you lose your tooth in the future, the crown lengthening might make it more difficult for the surgeon to place a dental implant.

The recovery process

The recovery time for this procedure is approximately three months. However, you’ll be able to resume normal functions as your gums heal. You only need to avoid strenuous activity for the first two to three days. A physically demanding job, heavy lifting, and heavy exertion could inhibit your healing and cause more bleeding.

Talk to your surgeon about the specifics of your recovery. In general, follow these guidelines:

Take OTC or prescription medication: In your aftercare instructions, you’ll most likely be told to take ibuprofen or Tylenol at regular intervals. The doctor may prescribe antibiotics, as well as extra-strength painkillers such as acetaminophen-hydrocodone (Vicodin), Tylenol with codeine #3, or acetaminophen-propoxyphene (Darvocet).

Use an ice pack: Using a pack on your face for the first few hours after the procedure can reduce swelling. Alternate use of the ice pack, following 20 minutes on and 20 minutes off. You may switch to moist heat a couple days after surgery.

Avoid hot foods for the first 24 hours: Also, don’t rinse your mouth. Both can make the bleeding last longer. If bleeding continues, use a moistened tea bag or moistened gauze to apply slight pressure to the area for 20 to 30 minutes.

Leave dressings in for 7 to 14 days: The doctor may replace the dressing once or twice during this period.

Brush carefully: Gently brush only your biting surfaces where the dressing has been applied. Brush and floss normally in other areas. Chew on the opposite side of your mouth from the dressing.

Wear your stent or denture: If wearing a clear stent or upper denture was included in your instructions, don’t remove it for 24 hours. If your mouth pools with blood, rinse with lukewarm saltwater or Chlorhexidine rinse, without removing the stent or denture. After 24 hours, you may wear it as desired.

Eat a soft food diet: Avoid the surgical area when you eat. Also, don’t eat anything hard, brittle, acidic, spicy, sticky, or highly seasoned. Avoid nuts and small seeds. Drink plenty of fluids.

Avoid alcohol: Refrain from drinking until after your post-op appointment.

Avoid smoking: Refrain from smoking for the first 7 to 10 days or longer.

Avoid prodding the area: Avoid using straws and playing with the surgical site with your tongue or finger. Don’t pull down your lip to check the site, as the pressure can cause damage.

Outlook after the procedure

Oral surgeries are continually becoming more efficient and effective. Crown lengthening is a common dental procedure performed for both dental and aesthetic purposes. When performed by a qualified professional, you can expect your procedure to go smoothly and increase the health and longevity of your teeth.