What Is Crown Lengthening?

Crown lengthening is a dental procedure that exposes more of a tooth by reshaping the gum tissue, and often a small amount of the bone, around it. Dentists recommend it for two main reasons: to reach enough healthy tooth structure to restore a tooth that has broken or decayed near the gum line, and to correct a gummy smile, where the teeth look short because gum tissue covers too much of them.

If you have just been told you need crown lengthening, or you are wondering whether it could help your smile, this guide explains what the procedure involves, why it is done, what recovery generally looks like and which questions are worth asking. It also explains how Dr. Steven W. Haywood, DDS approaches damaged teeth and gummy smiles at the Timonium office, and what a consultation there can tell you about your own tooth.

What crown lengthening actually is

The “crown” in crown lengthening is the part of the tooth you can see above the gums, not a dental crown. The procedure does not make the tooth itself any longer. It moves the gum line, and where needed the supporting bone, so that more of the natural tooth is exposed.

Gum tissue only, or gum and bone

In some cases only excess gum tissue needs to be reshaped. In others, the bone beneath the gums also sits too close to where the new gum line or the edge of a restoration needs to be, so a small amount is recontoured to let the gums heal in a stable position. Which one you need depends on how your gums and bone are shaped around the tooth, and that is something only an exam and X-rays can show.

Why the gums need room

Gum tissue attaches to the tooth in a narrow zone just above the bone. If the edge of a filling or crown is pushed down into that zone, the gums around it tend to stay irritated and hard to keep clean. Crown lengthening creates space, so the restoration can sit on sound tooth structure while the gums attach comfortably above the bone.

Why crown lengthening is done

To restore a broken or decayed tooth

When a tooth breaks at or below the gum line, when decay extends under the gums, or when an old crown fractures, there may not be enough tooth showing for a new restoration to hold onto. A dental crown needs sound tooth structure to grip and seal against. Crown lengthening uncovers that structure so the tooth can be rebuilt on a solid foundation instead of being removed.

At Dr. Haywood’s practice, conservative options come first. Where a filling or a bonded onlay will do the job, that is the first recommendation, because it keeps more of your natural tooth. A porcelain crown is used when a tooth is extensively damaged or cracked, or after a root canal, and a crown can often save a tooth that would otherwise need to be pulled. Read more about dental crowns and the full range of restorative dentistry in Timonium.

To correct a gummy smile

A gummy smile is when a large amount of gum shows when you smile, so the upper teeth look short or overtaken by the gums. Often the cause is excessive gum tissue rather than short teeth. Your smile line is shaped by your facial muscles, your lips, your teeth and your gum tissue, so the right correction depends on which of those is responsible.

Dr. Haywood corrects gummy smiles with a gum lift, which moves the gums upward on the upper teeth for ideal tooth proportions, using a dental laser or radiosurgery. For a small movement of the gum or a little reshaping, radio-surgical technology is used in almost all cases. For a major gum lift or minor gum recontouring, the Haywood surgical smile makeover combines the gum surgery with same-day customized veneers that help guide tissue healing, so you can walk out with a new gum line and smile.

To balance the gum line before cosmetic work

When gum heights vary from tooth to tooth, veneers or crowns placed on top can look uneven no matter how well they are made. Adjusting the gum line first gives the new teeth balanced proportions, which is why gum treatment is often one step in a larger cosmetic plan rather than a procedure on its own.

What happens during a crown lengthening procedure

Techniques vary between dentists and between cases, but the general sequence is similar.

1. Evaluation. The dentist examines the tooth and gums, takes X-rays, reviews your medical history and any health conditions, and plans where the new gum line should sit.
2. Numbing. The procedure is typically performed under local anesthesia, so the area is numb while the work is done. Sedation can help if you are anxious.
3. Reshaping. Gum tissue is reshaped or removed, and bone is recontoured if the plan calls for it. Depending on the technique, the gums may be stitched in their new position. Lasers are used for many soft-tissue procedures.
4. Protection while you heal. A damaged tooth may be covered with a temporary crown while the gums settle.
5. The final restoration. Once the tissue has healed, a permanent crown or other restoration is made to fit the new gum line.

A crown itself is usually completed in two appointments at the practice: the tooth is prepared, an impression is taken and a temporary crown is placed, and at the second visit the permanent crown is checked for fit, bonded and polished.

Is crown lengthening painful?

Because the area is numbed, most people feel pressure rather than pain during the procedure. Once the anesthetic wears off, some tenderness and swelling around the surgical area is common, and it is usually managed with over-the-counter pain relievers taken as your dentist directs. How much discomfort you feel depends on how many teeth are treated and whether bone was reshaped.

If the thought of dental surgery makes you nervous, say so. At the practice, laughing gas is breathed through a comfortable nasal mask and wears off quickly, so you can drive yourself home. Oral conscious sedation is a pill taken about an hour before your appointment; it lasts several hours, so you will need a ride. See sedation dentistry for more.

Recovery and aftercare

Your dentist will give you care instructions for your own case, and following them closely is the best way to heal well. Typical aftercare instructions include:

• Eat soft foods and chew on the other side of your mouth at first.
• Avoid smoking, which slows healing.
• Keep the area clean, brushing gently near the treated teeth and rinsing as instructed.
• Leave any stitches or dressing alone.
• If you had sedation, do not drive or operate machinery while its effects last, which can be several hours.
• Call the office if bleeding, swelling or pain gets worse instead of better.

Healing time varies from person to person and depends on whether bone was involved. The final crown waits until the gums are stable, so your dentist will tell you when complete healing allows the permanent restoration to be made.

Possible risks and side effects

Crown lengthening is a routine procedure, but like any surgery it has trade-offs worth understanding before you agree to it.

• Tooth sensitivity. More of the tooth is exposed, and it may be sensitive to hot and cold for a while.
• Longer-looking teeth. That is the goal for a gummy smile, but on a single back tooth it can make the treated tooth look longer than its neighbors.
• Small spaces near the gum line. Gum tissue between neighboring teeth may not fill in completely.
• The usual surgical risks. Bleeding, swelling and infection are possible, which is why aftercare matters.

Alternatives worth discussing

Crown lengthening is one option, not the only one. For a gummy smile, a gum lift, veneers or a combination may achieve the result you want, and before-and-after cosmetic imaging, part of every cosmetic evaluation at the practice, lets you preview possible changes before you commit.

For a broken tooth, the answer depends on how much of the tooth is left and where the break is. Many cracked teeth can be saved with restorative and surgical procedures, though a tooth split along its root cannot. When a tooth can’t be saved, dental implants replace the root and crown without touching the healthy teeth beside it, and Dr. Haywood provides every phase of implant care in the same office.

Whether crown lengthening, a gum lift or another approach suits your tooth is something Dr. Haywood can assess at a consultation, with personalized care built around your goals, your comfort and your budget.

Cost, insurance and financing

There is no single price for crown lengthening. The fee depends on how many teeth are involved, whether bone needs reshaping and what restoration follows. The practice is out of network with all dental insurance providers: you pay at the time of your visit, and the office files the claim so your plan can reimburse you for whatever it covers. HSA and flex plans are welcome. Financing is available through CareCredit, with no-interest options up to 12 months, and Cherry, with plans from 3 to 24 months. See financing options.

Frequently asked questions

Is crown lengthening the same as a gum lift?

They overlap. Both expose more of the tooth. A gum lift reshapes the gum line, usually for cosmetic reasons, while crown lengthening can also involve reshaping bone, often so a damaged tooth can be restored. Your exam shows which one your smile or tooth needs.

How long does crown lengthening take to heal?

It varies with the size of the area treated and whether bone was reshaped. The gums need to be stable before a final crown is made, so your dentist sets the timing for your permanent restoration after checking how you have healed.

Will my teeth look longer afterward?

Yes, more of the tooth will show. For a gummy smile that is the aim: balanced tooth proportions. For a single restored tooth, it is worth asking in advance how the treated tooth will look next to its neighbors.

Can a tooth broken below the gum line be saved?

Often, yes. Exposing more sound tooth structure can give a crown something solid to hold onto. A tooth split along its root cannot be saved, and then replacement options such as an implant or a bridge are discussed.

Talk to Dr. Haywood about a broken tooth or a gummy smile

If a tooth has broken near the gum line, or too much gum shows when you smile, find out what your options are. Request an appointment or call (410) 453-9399. The office is at 108 W Timonium Rd, Ste 200, Timonium, MD 21093, and new patients are always welcome. Dr. Steven W. Haywood, DDS has more than 35 years of experience in cosmetic, restorative and implant dentistry.