Crown Lengthening

The part of the tooth that is seen above the gum is called the clinical crown. When not enough of the clinical crown is showing, the gum must be moved up the root to expose more teeth. This is called crown lengthening.

There are two situations in which crown lengthening is commonly performed;

• To improve the appearance of irregular gum levels
• To allow a dentist better access to decay or to replace a crown.

Most crown lengthening procedures are very straightforward and there is little or no post-operative discomfort. Sutures and dressing are removed after about 2 weeks and is many cases a minor “touch-up” surgery is done after about 4-6 weeks to establish ideal tissue form.

A second common use of crown lengthening is to access decay. If the dentist is unable to reach decay that is deep under the gum, the tooth will be lost. As a rule, simply trimming back the gum is not sufficient, as the bone would be exposed. Rather, the periodontists must reflect a flap, trim back the bone to allow for access to the decay and then suture the gum back at the lower level. Sufficient bone must be removed to allow room below the decay for the gum to reattach to the tooth.

Irregular Gum levels detract from an attractive smile. Even with new crowns, the results can never be satisfactory unless the gum has a natural contour. This may be as simple as changing a single tooth or may involve all the upper front teeth.

Regardless of the beauty of the crowns or veneers, unless the gum line is contoured in a pleasing manner, the esthetic results will be poor. Scalloping the gum to a pleasing form is generally very easy for the patient, with minimal post-operative discomfort. The general dentist should wait for 8-10 weeks before the final crowns are completed, to ensure the gum has healed to its final level. If the patient feels the teeth look too long during the healing phase, temporary crowns can be made.

The gummy smile makes the teeth look short and not in proportion with the patients face. By sculpting the gum to make the teeth appear more natural, the smile can be greatly enhanced.