Crown lengthening is a surgical procedure where the surgeon removes gum tissue or bone or both to expose more of a tooth surface. This procedure can be undertaken to promote gum health or for cosmetic purposes. It is a common surgical procedure performed on a single tooth or multiple teeth.

Many of you may not be aware of the procedure or the term itself. In this article, I will explain what crown lengthening means.

The article will also deal with the procedure, the steps involved in the surgery, the precautions you need to follow and the probable risks.

What is the crown of a tooth?

Crown of a tooth is the visible tooth surface in the mouth and covered by enamel, which is the hardest substance in the body.

The artificial dental crown is tooth-shaped ‘cap’ placed over a tooth to restore normal functioning in case of decay or fracture of the anatomical crown.

What is crown lengthening procedure?

Crown lengthening is an oral surgery treatment that involves removing excess gum tissue and some bone tissue (at times) to make the crown of the teeth appear longer.

Previously, this procedure was performed by dentists as a dental procedure to improve dental health. Of late, this procedure is used for esthetic purposes also.

For example
  • Dental health – When the decay or fracture on the anatomical crown is sub-gingival (under the gum line), crown lengthening procedure helps expose more of the tooth’s crown to support a filling or a porcelain crown. Crown lengthening is used to prepare the area for a new restoration to correct the damaged teeth. (1)
  • Esthetic purpose – If gum line is uneven, crown lengthening procedure can sculpt the gum line to produce a more symmetrical smile.

Excess gingival display results in the appearance of short clinical crowns. In such cases, a crown lengthening procedure can beautify a person’s smile.

The dentist reshapes the gum line and exposes the crown of the teeth which makes the teeth appear long after the operation.

Crown lengthening procedure contours gum tissue or bone tissue to expose the crown of the tooth or sculpt the uneven gum line. (2)

Preparation of teeth for crown lengthening procedure

You will have to visit your periodontist for the surgery. He will take x-rays, review your medical history and set a date for surgery.

You may have to undergo a round of professional cleaning before the procedure. If you have to discontinue any medication, your dentist will inform you of the same in the first visit.

If the tooth requires a crown, then your dentist will fit a temporary crown. This crown will make it easier for the dentist to decide on how much exposure is necessary. Also, the crown protects the tooth.

Steps in crown lengthening procedure

This will be an outpatient procedure performed under local anesthesia. The time taken will depend on the number of teeth and if both hard tissue and soft tissue have to be removed. For example, the removal of just soft tissue takes less time than the removal of both hard and soft tissue.

The periodontist cuts the gum tissue to pull the gums away from the teeth, exposing the roots and bone. In some cases, only a small portion of gum is removed which is enough for your dentist to place a crown or filling.

Once, enough gum tissue is exposed, the dentist will clean the area with saline water and stitch the gums after repositioning.

Some dentists also apply a pack over the stitches to prevent infection. If you have any temporary crowns on the involved teeth, the dentist will remove the crown and place it back after the procedure.

You will be given prescriptions for a painkiller and mouth rinse. You will have to follow a semi-liquid diet and avoid brushing the region where the stitches are. Also, brush softly and if any food particle is stuck in your teeth, then remove it with water irrigator or toothpick. (4)

Follow up after the procedure

The gums take around three months to heal completely. But you can resume normal functions in a week or two. You will need to avoid strenuous exercises like weight-lifting, power yoga or any work which is physically demanding for a day or two. Heavy work will inhibit healing and may cause excessive bleeding. (3)

Your dentist will give you specific instructions to follow. A few general guidelines are –

  • Painkillers – You will have to take painkillers subsiding the pain. The dentist may also prescribe antibiotics for protection from any oral infection.
  • Ice-pack – Use ice compress on your face, a few hours after the procedure. The ice compress will help reduce the swelling. After two days, shift to a moist compress.
  • Say no to hot food and solid food – For two days, do not eat hot liquids or hot food and solid food. On the day of the procedure, your diet should comprise of ice creams and cold food and liquid or semi-solid food. After 24 hours, you can eat warm food but avoid solid food. Drink plenty of fluids. Avoid eating nuts or sticky food. Eat bland food. Spicy food can be detrimental to the healing process.
  • Do not rinse your mouth – On the day of the procedure, do not spit or rinse your mouth. Both the act may cause bleeding to last longer.
  • Leave dressing for 7-14 days – the dressing pack which your dentist places over the stitches, keep them for two weeks. Your dentist mi=ay change them once or twice in- between.
  • Brush with caution – Do not brush over the stitches. Be careful while you brush the region near the stitches. For two weeks, be very gentle on the operation site so as not to cause harm. Brush the other side in the usual manner.
  • Abstain from smoking and drinking – Do not smoke or drink alcohol till the time your dentist gives you the thumbs-up. Quitting smoking would always be a welcome change. Also, adhering to the precautions is the least you can do for your health.
  • Avoid touching the area– do not touch the area or prod with straws. Refrain from using your tongue to feel the site. You will end up causing some damage.

 Possible risks

You should contact your dentist if any of these happens with you –

  • Bleeding doesn’t stop
  • Painkillers are not helping curb the pain
  • Infection
  • Swelling or discharge from the operation site
  • Swollen lymph nodes
  • Bandage falls off sooner than expected.

Over to you on crown lengthening

Crown lengthening is a common dental procedure performed for both dental and aesthetic purposes. When you get your surgery done by a gum specialist, the operation will be smooth-sailing for you.

The procedure will increase the longevity of your teeth, improve your overall dental health. If you are worried about your gummy smile, you now know what to do.

Crown lengthening procedure is a surgical process where the surgeon removes gum tissue or bone or both to expose more of a tooth surface.
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