Crown Lengthening

Crown lengthening is a surgical procedure performed by a dentist to expose a greater amount of tooth structure for the purpose of subsequently restoring the tooth prosthetically. This is done by incising the gingival tissue around a tooth and, after temporarily displacing the soft tissue, predictably removing a given height of alveolar bone from the circumference of the tooth or teeth being operated on. While some general dentists perform this procedure, others frequently refer such cases to periodontists.

Before crown lengthening is done, you will visit a periodontist. At this visit, the periodontist will review your medical history and your X-rays. He or she will set a date for the surgery.

Before the surgery, you may get a professional tooth cleaning.

If the tooth needs a crown, your dentist may put on a temporary crown. This protects the tooth. It also makes surgery easier, because the periodontist will be able to see how much soft tissue or bone to remove.

After surgery, the area will heal in about three months. Then your dentist will prepare the tooth again. He or she will make a new temporary crown to fit the lengthened tooth. Then he or she will make the final crown.

Crown lengthening is done using local anesthesia. How long it takes will depend on the number of teeth that need treatment. Even if only one tooth is involved, crown lengthening typically includes neighboring teeth, too. That allows the tissues to be reshaped gradually. If both bone and soft tissue are removed, the procedure will take longer than if only soft tissue is removed.

The periodontist will make cuts that will pull the gums away from the teeth. This will expose the roots of the teeth and the surrounding bone. In some cases, simply removing a little gum tissue will expose enough tooth for your dentist to place a crown or filling. However, in most cases, the periodontist will need to remove some bone from around the roots of the teeth. Once the periodontist has exposed enough tooth, the surgical area will be washed with sterile salt water and the gums will be stitched together. Some dentists put a bandage over the stitches.

If you have temporary crowns on any of the involved teeth, the crowns may be removed before the procedure begins. The periodontist will put them back afterward.

You will be given prescriptions for a pain reliever and a mouth rinse. Your dentist will ask you to follow a somewhat soft diet. You can brush the teeth near the stitches, but avoid the gums. Remove food particles with a toothpick or a water irrigator.

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