When is crown lengthening necessary?

Sometimes, when you visit your dentist to have a cavity filled or a crown applied, he or she may recommend that you also undergo a crown lengthening. Because this is a surgical procedure, it may very well catch you off guard. However, if recommended, there is usually a good reason for the procedure.

What Is Crown Lengthening?

Crown lengthening is a procedure that is designed to reshape your gums at the base of the affected tooth in order to expose more of the tooth’s surface; and, if deemed necessary, to adjust the tooth’s bone level so that the height or size of the visible portion of the tooth can be extended so that the new restoration has enough surface area to be held in place.

To bond with a crown, your gums need, at the very least 2 millimeters of surface area. This not only helps with bonding but prevents the trapping of foods or other potential complications like various restorative dental appliances weakening or falling off of the tooth.

Crown Lengthening: When Is it Necessary?

Crown lengthening is recommended for an array of dental conditions. The most common conditions requiring crown lengthening are: teeth that are too short, tooth decay that is severe below the gum line, or a broken or fractured tooth beneath the gum line.

When a tooth experiences severe decay or breaks, the healthy area that remains is reduced. This affects the success rate of tooth restoration as restorative dental appliances have little surface area to work with. Crown lengthening is the attempt to improve the success rate of restorative dental appliances by exposing more of the tooth’s healthy surface area. With more surface area to work with, various dental appliances have a greater chance of staying put and not weakening or falling off.

The Procedure: What to Expect

Crown lengthening is a common procedure and, while intimidating at first, is not something that a patient should be wary off. Most crown-lengthening procedures can be performed in under one hour and are done in an outpatient facility. Before the procedure, you will likely be fitted with a temporary crown; this is to ensure that your tooth remains protected until your permanent crown can be placed around a month after your crown-lengthening procedure.

Performed by a periodontist (gum specialist) while under a local anesthetic (if you have anxiety associated with dental procedures, you can request other methods of sedation), the area of gums surrounding the tooth and the underlying bone in question will be recontoured using specialized surgical instruments. Your periodontist will recontour the gums and underlying bone until the teeth are of an appropriate length for proper dental appliance application and are symmetrically pleasing.

Following the procedure, most patients do not need a great deal of post-operative care other than slight pain management using over-the-counter medications like ibuprofen. An ice pack can help with any facial swelling and alcohol use and smoking should be avoided. You can return to work and can begin eating soft foods the day after the surgery but should avoid strenuous activity for two days. Full gum tissue recovery, however, will take one to two weeks; this is when your periodontist will remove your stitches.

After four to six weeks, your periodontist will inspect your teeth and gums before clearing you for your permanent restoration.

It is important to note that in the first 24 hours following the procedure, hot foods should be avoided. You may experience an increased sensitivity to hot and cold foods – this is normal. Because the roots of your teeth are now exposed, your sensitivity will increase. However, this will go away with time or when you have your permanent crown applied.

When to Contact Your Periodontist

Following a crown-lengthening procedure, be sure to keep an eye out for any complications. While complications are rare, they include:

  • Bleeding that will not cease
  • Pain despite ibuprofen use
  • Infection
  • A lot of swelling or discharge from the area
  • Your bandage loosens or falls off
  • The formation of lumps (swollen lymph nodes) under your jaw or in your neck

If you notice any of the symptoms above, call your periodontist immediately so that he or she can remedy the complication.

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