Dental Crown Lengthening

Crown lengthening is usually performed to improve the health of the gum tissue, prepare the mouth for a procedure, or correct a “gummy smile.” A “gummy smile” is used to describe an instance where teeth are covered with excess gum tissue resulting in a less esthetically-pleasing smile. The procedure involves reshaping or recontouring the gum tissue and bone around the tooth in question to create a new gum-to–tooth relationship. Crown lengthening can be performed on a single tooth, many teeth, or the entire gum line.
Crown lengthening is often required when your tooth needs a new crown or other restoration. The edge of that restoration is deep below the gum tissue and not immediately accessible. It is also usually too close to the bone or below the bone.
Crown lengthening allows us to reach the edge of the restoration, ensuring a proper fit to the tooth. It should also provide enough tooth structure so the new restoration will not come loose in the future. This allows you to clean the edge of the restoration when you brush and floss to prevent decay and gum disease.
Crown lengthening takes approximately one hour but will largely depend on the amount of teeth involved and if any amount of bone will need to be removed. The procedure is usually performed under local anesthetic and involves a series of small incisions around the tissue to separate the gums from the teeth. Even if only one tooth requires the procedure, it will probably be necessary to adjust the surrounding teeth to enable a more even reshaping. In some cases, extraction of a small amount of bone will be necessary as well.

Reasons for crown lengthening
Crown lengthening is a versatile and common procedure that has many effective uses and benefits.  The vast majority of patients who have undergone this type of surgery are highly delighted with the results.
Here are some of the most common reasons for crown lengthening:

• Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay. Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth.
• Cosmetic uses – Extra gum tissue can make teeth look unnaturally short, and also increase susceptibility to periodontal infections. Removing excess gum tissue can restore a balanced, healthy look and thus improve the aesthetic appearance of the smile.
• Dental crowns – Crown lengthening serves to provide more space between the supporting jawbone and dental crown. This prevents the new crown from damaging gum tissues and bone once it is in place.

What does crown lengthening involve?
Crown lengthening is normally performed under local anesthetic.  The amount of time this procedure takes will largely depend in how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue.  Any existing dental crowns will be removed prior to the procedure, and replaced immediately afterwards.
The dentist will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth.  Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping.  Separating the gums provides the dentist with access to the roots of the teeth and the underlying bone.
In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown.  In other cases, the dentist will also need to remove a small amount of bone from around the teeth.  The bone is usually removed using a combination of special hand instruments, and rotary instruments.  The rotary instruments roughly resemble the drill that is used in cavity treatment.
When the dentist is satisfied the teeth have sufficient exposure, the wound will be cleaned with sterile water and the gum tissue will be sutured with small stitches.  The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned.
The dentist will secure the surgical site using an intraoral (periodontal) bandage, which serves to prevent infection.  Prescriptions may be provided for pain medication, and a chlorhexidine (antimicrobial) mouth rinse may be given to help reduce any bacteria attempting to re-colonize.  The surgical site will be completely healed in approximately two to three months.

Why You Should use a Periodontist for Crown Lengthening?
While many general dentists offer crown lengthening services, periodontists are specifically trained to handle this rigorous procedure. Periodontists undergo years of extra training to understand the gingival structures of the mouth. Our certified periodontist understands how to anticipate and resolve issues that might come up during your procedure. If you think that you could benefit from crown lengthening, make an appointment with our Natick office.  We serve Natick, Sherborn, Dover, Wellesley, Framingham, Wayland, Needham, Ashland, Holliston, and Southborough.

Recovery period
Your periodontist will provide you with a prescription for managing any pain or discomfort. You will be provided with a special mouth rinse and dental care instructions during recovery stages. You will be able to continue your normal oral hygiene routine. However, during recovery it is best to avoid the gum area of the procedures for a few weeks.
Your periodontist will want to see you back within about a week to remove the stitches. After the stitches are removed your gums will need some time to heal before your dentist finishes restoration or cosmetic treatment of the tooth.