Crown lengthening is a surgical procedure that involves a reduction in the height of the gumline and the underlying bone around one or more teeth. It’s a procedure that is commonly and safely performed in the dental office under local anesthetics (and sedation when necessary). Your periodontist will make every effort to ensure that your surgery is as smooth and as stress-free as possible
What Is Crown lengthening?
This is a common surgical treatment. The operating surgeon removes gum tissue, bone or each to expose more of a tooth.
What Crown lengthening Used For
Crown lengthening is completed once a tooth needs to be fixed. Sometimes, not enough of the tooth sticks out above the gum to support a filling or crown.
This can happen once a tooth breaks off at the gum line. It can also happen once a crown or filling falls out of a tooth and there’s decay beneath. to put a filling or crown, your dental practitioner must expose more of the tooth. this is often done by removing some gum tissue or bone. Some individuals have a lot of gum tissue around their upper teeth. Dentists call this “gummy smile.” This can also be treated with crown lengthening.
Preparation of crown lengthening
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.
How crown lengthening is Done
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 the 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.
For the first few hours, use ice on your face over the area of surgery. This will reduce swelling.
You will go back to the periodontist in 7 to 10 days to have the stitches taken out. You will go back again 4 to 6 weeks later for a follow-up visit.
Your gums should heal for about three months before the tooth is prepared for the final crown. Gums can shrink
as they heal. If you don’t wait long enough, the edges of the crown could show. Your regular dentist will put in the crown or filling.
Risks of crown lengthening
The area may bleed for some time after the procedure. In addition, an infection may develop after the surgery. These complications may occur after any type of surgery.
Some people find that after the surgery, their teeth are sensitive to hot and cold. This is because the roots of the teeth are now exposed. The sensitivity goes away with time, or when a crown is put on the tooth.
Because of the tissue and bone removal, the affected tooth may look longer than the teeth next to it.
Removing bone from around a tooth can make it feel looser. If that tooth is ever lost, it could be more difficult to put in a dental implant to replace it. Your periodontist will talk about these possibilities with you.
When To Call a Dental Professional
- You have bleeding that doesn’t stop
- Your pain reliever isn’t helping
- You think the area might be infected
- You notice a lot of swelling or discharge from the area
- The bandage becomes loose or falls off
- You notice tender lumps beneath your lower jaw or in your neck (these are swollen lymph nodes)
DENTAL CROWN LENGTHENING PROCEDURE
You may have asked your periodontist about procedures to improve a “gummy” smile because your teeth appear short. Your teeth may actually be the proper lengths, but they’re covered with too much gum tissue. To correct this, your periodontist performs a dental crown lengthening procedure.
During the dental crown lengthening procedure, excess gum and bone tissue are reshaped to expose more of the natural tooth. This can be done to one tooth, to even your gum line, or to several teeth to expose a natural, broad smile.
Your dentist or periodontist may also recommend dental crown lengthening to make a restorative or cosmetic dental procedure possible. Perhaps your tooth is decayed, broken below the gum line, or has insufficient tooth structure for a restoration, such as a crown or bridge. Crown lengthening adjusts the gum and bone level to expose more of the tooth so it can be restored.
Understanding your responsibilities and being prepared for the days and weeks following the surgery will help make the procedure a success.
From pain medications to the recommended foods, here’s what you can expect:
Pain Management After the anesthetics wear off, mild to moderate discomfort is to be expected. Aspirin-free pain relievers are most helpful when they are taken, on schedule, as directed. Waiting too long between dosages, or waiting until you are in pain will only subject you to unnecessary discomfort.
Swelling and Bleeding During the first 48 hours, 20-minute cycles with a simple ice pack may be enough to keep the swelling to a minimum. After about 2 days, trading your ice pack for moist heat is recommended.
Bleeding should be minimal and can be controlled with gentle, steady pressure. Avoiding hot foods, strenuous activities, and medications that contain aspirin will also prevent excessive bleeding.
Healing The teeth near the surgical site may be sensitive to cold temperatures for a few weeks. As healing progresses, the sensitivity should decrease, and it will be important to keep the area as clean as possible.
A firm surgical dressing may be used to cover and protect the treated area for 1-2 weeks, though it may be changed during that time at your follow-up visits. You will receive instructions on how to care for this area and your efforts will help to promote healing.
Diet and Homecare Soft, bland foods are best during the recovery period, and chewing on the untreated side of the mouth is recommended. Alcoholic beverages should be avoided as they are known to promote bleeding and slow healing.
Following your meals and snacks, make an effort to clean your entire mouth, including rinsing with the antiseptic mouthwash that has been recommended by your periodontist.
After crown lengthening surgery, make it your mission to follow the guidelines as closely as possible. Contact our skilled periodontal team today to learn more about the procedure.