Crown Lengthening Procedure

Sometimes not enough natural tooth is exposed to hold a crown firmly, for example, if a tooth is broken or has extensive decay. Crown lengthening is a procedure that reduces the amount of gum tissue around the tooth and which can reshape the bone around the tooth when necessary.Crown lengthening exposes more of the natural tooth structure above the gum line, enabling a dental crown to be fitted correctly. It’s essential to make sure dental crowns are fitted properly to ensure good comfort and to enable ongoing oral hygiene care. Some people use crown lengthening to expose more of their natural teeth, for example, when they have a gummy smile.

If you have a tooth that is broken down or decayed, we may fit you with a temporary crown until you can have crown lengthening surgery. The temporary crown will protect your tooth and will help make it easier to fit your new crown after surgery is complete. We perform the periodontal procedure using local anesthesia, although we can also use sedatives if needed. The time required for surgery depends on the number of teeth we are treating and the amount of gum tissue and bone that must be removed and reshaped. Several surgical techniques may be used depending on the excess tissue to be removed and your oral health.

Any temporary crowns are removed, and we carefully cut into the gums to expose the teeth underneath. Sometimes it’s only necessary to remove gum tissue, but other times we will need to expose the tooth root and bone to reshape these accurately.

A surgical extrusion procedure is where the tooth is moved to an improved location above the gumline. It is a technique that can help if your tooth has fractured beneath the gum. Afterward, we clean the area thoroughly and stitch your gums. If the tooth in question needs stabilizing, we may wire or splint it to the adjacent teeth during healing. Sometimes we may place a bandage over the area for additional comfort and protection.

The question most people want to know is if crown lengthening causes pain. The answer depends on the type of procedure and the experience of the dentist completing this treatment. Our dental team is highly skilled, and we collaborate closely with other dental specialists to ensure our patients always receive the very best care.

During the actual procedure, we will make sure the area is thoroughly numbed, so you do not experience pain. As the anesthesia wears off, you may feel some discomfort. Anti-inflammatory medication like ibuprofen or acetaminophen can help relieve inflammation and discomfort after treatment. It’s normal to experience minor swelling and possibly some bleeding during the first few days after crown lengthening surgery. We can advise you on using a cold compress to help relieve discomfort and swelling.

We will discuss how to care for your mouth at home before you have this treatment and immediately afterward before you leave our dental office to recover at home. As you recover, make sure you follow our instructions closely.

• Use over-the-counter pain relief and take prescription medication as recommended.
• Use an ice pack to reduce facial swelling the first two days after surgery, placing the pack on your face for 20 minutes on and 20 minutes off.
• After the first two days, use a moist heat pack to continue reducing swelling.
• Avoid eating hot foods for the first 24 hours. If possible, chew on the opposite side of your mouth to the surgical site.
• Don’t eat any spicy foods and avoid anything that is very acidic or highly seasoned or sticky. Also, don’t eat anything with small seeds or nuts that could get stuck in your gums.
• Drink plenty of fluids during healing but avoid alcohol.
• If the surgery site is bleeding, use a moistened piece of gauze and apply gentle pressure to the area for 20 minutes. Alternatively, use a moist tea bag to help stop bleeding.
• Leave any dressings in place until they are ready to be removed. We can replace these dressings for you during the healing period.
• Brush your teeth carefully, avoiding areas where there is a dressing. You can brush and floss your other teeth normally. We may also prescribe chlorhexidine mouth rinse for use after surgery.
• Avoid smoking for at least the first week and preferably for longer.

As healing continues, the swelling and discomfort will disappear, and your gums will begin to shrink so you can see the effects of surgery more clearly. Healing after crown lengthening surgery can take several months to complete fully. If you need a dental prosthesis such as a crown or bridge after surgery, we may want to wait until healing is complete before we fit this device.

Crown lengthening is quite a routine surgical treatment which should go smoothly. It can be very helpful in protecting your oral health and preserving your natural teeth.