Crown Lengthening

When you hear the world “crown” at the dentist, you probably think of the cap put over a tooth to repair & protect it. And you’d be correct. But there’s another meaning to the word “crown” in dentistry. In general, “crown” refers to any tooth structure that sits above the gumline. The term can refer to the top part of your tooth that’s visible above your gums, a cap on a damaged tooth, or even the artificial tooth that is cemented to a titanium dental implant.

In a crown lengthening, the crown being referred to is the crown portion of your natural tooth. Dental crown lengthening is when gum tissue and/or bone is removed to expose more of a tooth, usually in order to repair it. If you have a tooth that is broken off at the gum line due to an accident or tooth decay, the dentist will need to perform a crown lengthening before repairing the tooth. That’s because there just isn’t enough tooth structure above the gums for an artificial crown (or a filling) to attach to. Trying to fit a crown on such a tiny foundation would make it ill-fitting, uncomfortable & at a higher risk of irritation, chronic inflammation, & further tooth decay & damage. It’s a better choice to remove some of the tissue around your tooth & seat the crown properly.

Crown lengthening is considered an oral surgery procedure & may be performed by either the dentist or a specialist, such as an oral surgeon or a periodontist (a dentist specializing in gum disease care). Based on your particular situation, crown lengthening may be done on one or several of your teeth, depending on what kind of other tooth repairs or replacements will follow. The procedure is simple enough that it can usually be performed right here in our office. To make you comfortable during the procedure, we will administer local anesthesia to keep you numb. If you are nervous about dental treatments, we can also discuss the possibility of using dental sedation to keep you relaxed.

The first step in the procedure is to gain access to the structure of your tooth. The dentist will make small cuts in your gum tissue to pull it away from your tooth, allowing access to the tooth root & your bone. In many cases, the bit of bone will need to be removed in addition to gum tissue. After the bone has been reshaped, the entire area will be washed & the gums stitched back together. Remember, you will not be able to feel any of this during the procedure because we will keep the area totally numb.

Crown lengthening is considered minor surgery in part because patients report relatively little pain in the recovery period afterward. Nevertheless, we recognize that people’s pain tolerances vary & we’ll recommend or prescribe the proper pain management medications in order to keep you comfortable after your crown lengthening. We’ll also provide all the instructions you’ll need for home care in order to make sure the incisions heal properly & comfortably, including how to clean the area & brush your teeth.

After about a week, you’ll come back to the office & we’ll remove the stitches & check how the healing process is going. Once your gums are fully healed, we’ll make arrangements for you to come in for your permanent dental crown.