Crown Lengthening

Crown lengthening is a surgical procedure that reshapes and recontours gum tissue and, when necessary, the underlying bone around a tooth. The goal is to expose more of the natural tooth structure so restorations such as crowns or bridges can be properly fitted and sealed. It is also commonly used for cosmetic reasons to reduce a gummy smile by creating a more balanced proportion between teeth and gums.

The procedure can be performed on a single tooth or on several teeth depending on the clinical goals and aesthetic concerns. Treatment planning typically includes a clinical exam and imaging to determine how much soft tissue and bone must be adjusted. The approach is tailored to preserve periodontal health while achieving predictable restorative or cosmetic outcomes.

Good candidates include patients who have excessive gingival display, teeth that appear short due to excess gum coverage, or teeth with decay or fracture extending below the gum line that require restoration. A thorough periodontal evaluation is important to confirm that the gums and supporting bone are otherwise healthy enough to undergo surgery. General health, smoking status and conditions such as uncontrolled diabetes are factors that will be reviewed during the consultation.

Imaging such as digital radiographs or CBCT scans may be used to assess bone levels and root anatomy before recommending crown lengthening. In some cases, preliminary periodontal therapy or stabilization of existing gum disease is required before surgery. The final treatment plan balances functional needs for restoration retention with long-term periodontal stability.

The procedure is usually done under local anesthesia and can be completed in a single visit for one or several adjacent teeth. The clinician makes small incisions to lift the gum tissue, removes or reshapes a controlled amount of bone when needed, and then repositions and sutures the gum margin at the desired level. Surgical time varies with complexity but is planned to minimize trauma while achieving the necessary tooth exposure.

Sutures are typically placed to stabilize the gum margins and promote healing, and postoperative instructions are provided to manage discomfort and swelling. In some cases, adjunctive tools such as lasers or piezoelectric instruments are used to refine soft tissue contours and reduce bleeding. Follow-up visits allow the clinician to monitor healing and determine the appropriate time to proceed with restorative treatment.

Initial recovery commonly involves mild to moderate swelling, minor bleeding and some discomfort that is well controlled with prescribed or over-the-counter analgesics. Soft tissue healing usually takes one to two weeks for the gum margins to feel comfortable, while complete maturation of the new gum position and bone remodeling can take several months. Patients are advised to follow a soft diet, avoid vigorous rinsing or spitting, and maintain gentle oral hygiene around the surgical site.

Careful home care and attendance at scheduled postoperative appointments help reduce the risk of complications and support predictable healing. Sutures are often removed or checked after one week and the clinician will confirm when the site is stable enough for final impressions or restorative work. Any unexpected symptoms such as severe pain, prolonged bleeding or signs of infection should be reported to the office promptly for evaluation.

As with any surgical procedure, crown lengthening carries risks such as postoperative infection, excessive bleeding, swelling, and transient sensitivity of the treated teeth. There is also a possibility of altered gum contours that may require minor additional adjustments, and in rare cases root sensitivity or exposure may result if too much tissue or supporting bone is removed. Careful diagnosis and conservative surgical technique are used to minimize these risks and preserve long-term periodontal support.

Close follow-up and adherence to postoperative instructions reduce the likelihood of complications and support optimal healing. If problems occur, early intervention can often resolve issues before they affect restorative outcomes. Your clinician will review the risk profile specific to your mouth and explain how they plan to manage potential complications.

Crown lengthening creates adequate tooth structure above the gum line so crowns and bridges can be properly seated with sound margins, improving retention and reducing the risk of recurrent decay. Establishing a biologic width and clear restorative margins helps maintain periodontal health and prevents inflammation around future restorations. Proper timing is important: final impressions or digital scans are generally taken after the gum margin has stabilized to ensure accurate fit.

The treated site may require several weeks to months of healing before final restorative work is completed, depending on the amount of tissue and bone adjusted. Close coordination between the surgical and restorative team ensures that crown height, margin placement and occlusion are optimized for both function and esthetics. Regular maintenance and professional cleanings after restoration placement help preserve long-term success.

Yes. When a gummy smile is caused by excess soft tissue or altered passive eruption, crown lengthening can lower the gum line and reveal more tooth surface to create a more balanced smile. The procedure reshapes the gum contours and, when necessary, adjusts bone levels to achieve lasting aesthetic results. A careful aesthetic analysis is performed to determine the ideal amount of tissue removal and the most harmonious tooth proportions.

Not all gummy smiles are caused by gingival excess; other factors such as a hyperactive upper lip, vertical maxillary excess or short clinical crowns may require different or additional approaches. During consultation, your clinician will review all contributing factors and discuss whether crown lengthening alone or in combination with other treatments will best meet your cosmetic goals.

Crown lengthening is primarily used on natural teeth to expose more tooth structure and is not typically performed on edentulous implant sites; however, soft tissue management is often an important component of implant and graft procedures. In cases where bone loss near natural teeth affects restorative planning, bone grafting may be recommended either before or in conjunction with soft tissue surgery to reestablish adequate support. Treatment sequencing is individualized to optimize both periodontal health and restorative outcomes.

Successful coordination between the periodontist and restorative dentist is important when implants, grafts or complex restorations are part of the plan. Digital imaging and careful surgical planning help determine whether simultaneous procedures are appropriate or whether staged treatment will deliver the best long-term result. Your clinician will explain the recommended sequence and how tissue changes from each step affect the final restoration.

Non-surgical alternatives may include orthodontic eruption to bring more tooth structure into view, restorative approaches such as lengthening crowns or veneers to change tooth proportions, and esthetic treatments like direct composite bonding. When a hyperactive lip contributes to a gummy smile, neuromodulator injections or lip repositioning procedures may be considered as adjuncts. Each option addresses different underlying causes and has its own benefits and limitations.

A diagnostic evaluation is necessary to determine whether non-surgical options will meet functional and aesthetic goals or if crown lengthening is the most predictable solution. The clinician will review anticipated outcomes, risks and timelines for each approach so you can make an informed decision that aligns with your priorities. Combining treatments is sometimes the best way to achieve a balanced, long-lasting smile.

Our office combines clinical experience with modern diagnostic tools to provide careful assessment and individualized treatment planning for crown lengthening cases. We emphasize conservative surgical techniques and coordination with restorative care to achieve lasting functional and aesthetic results while protecting periodontal health. Preoperative imaging and a team-based approach help ensure predictable outcomes tailored to each patient's needs.

During your consultation we review all viable options, explain the surgical process and recovery expectations, and schedule appropriate follow-up to monitor healing and restorative timing. The goal is to deliver care that supports long-term oral health and a confident smile through thoughtful planning and consistent postoperative support. If you have questions about how crown lengthening could fit into your treatment plan, our team will work with you to clarify next steps.