Crown lengthening is a gum procedure that removes a small amount of gum tissue, and sometimes bone, to expose more of a tooth. Redondo Beach Dental Group offers crown lengthening in Redondo Beach, a short drive from Torrance, Hermosa Beach and Manhattan Beach.
It is used to make room for a crown on a broken or decayed tooth, or to even out a gummy smile. If your dentist has said a tooth needs crown lengthening before it can be crowned, or you feel your teeth look short when you smile, call (310) 542-6988 to have the tooth and gums checked.
Why a Tooth Sometimes Needs More Room for a Crown
A crown has to grip healthy tooth above the gumline. When a tooth breaks off at or below the gum, or decay runs under an old filling, there may be too little tooth showing for a crown to hold onto or seal properly.
Pushing the edge of the crown deeper under the gum is not the fix. The gum attaches to the root over a short band just above the bone. In a 1961 study of human jaws from autopsies, published in the Journal of Periodontology, that attachment measured about 2 millimeters on average. When a crown edge sits inside that band, the gum tends to stay inflamed, bleed and pull away. Crown lengthening moves the gum, and the bone beneath it when needed, so the crown edge can sit on sound tooth with that space left intact.
This often comes up after a root canal, when a tooth has lost a lot of its structure, and before a same-day crown or a lab-made crown is placed.
Crown Lengthening for a Gummy Smile
A gummy smile is one where a lot of gum shows when you smile and the teeth look short, even though they are a normal length underneath. In many people the gum simply never moved back to its usual position as the adult teeth came in, so it still covers part of each tooth. Removing that extra tissue, and reshaping the bone under it where needed, shows more of the teeth and can make the gumline more even.
The cause matters. If the gum display comes from an upper lip that lifts very high or from the way the upper jaw grew, crown lengthening alone may change little, and a different approach may be needed. Cosmetic crown lengthening is often planned alongside other cosmetic dentistry, and when porcelain veneers are part of the plan, the gums are usually reshaped first so the veneers can be made to the new gumline.
What Happens During Crown Lengthening
- Exam and X-rays. The gums are measured and X-rays show where the bone sits, so the amount of tissue to remove can be planned.
- Numbing. The area is numbed with local anesthetic.
- Reshaping the gum. A small amount of gum tissue is removed or folded back from the tooth. For some cosmetic cases this is all that is needed.
- Reshaping the bone, in some cases. Crown lengthening sometimes includes reshaping bone; ask us whether yours would. When it does, a small amount of bone is smoothed back so the gum can heal at a new, stable level.
- Closing. The gum is placed in its new position, often with a few stitches.
The procedure is usually done in one visit; ask us about follow-up. If the tooth already has a crown or a temporary, it may be taken off for the procedure and put back afterward.
Healing and When the Final Crown Goes On
Some soreness and swelling for a few days is common, and over-the-counter pain relievers and a cold pack on the cheek usually help. You will be given instructions for brushing and rinsing around the area while it heals.
The gum keeps settling for weeks after the visible healing is done. That is why the final crown is not usually placed right away. A wait of several weeks is common for back teeth, and front teeth, where the gumline shows, often need longer so the edge of the crown does not end up visible later. A temporary crown can protect the tooth in the meantime. Your dentist will tell you when the tissue is ready.
When Crown Lengthening Is Not the Right Treatment
- Gums that have already pulled back from the teeth need the opposite treatment: gum recession treatment covers exposed roots instead of exposing more tooth.
- Gums that are red, swollen or bleeding need gum disease treatment first, often a deep cleaning such as scaling and root planing, because surgery on inflamed gums heals less predictably.
- A tooth broken far below the bone, or with a short root, may not have enough support left after lengthening. Removing it and replacing it can be the better long-term plan.
Risks to Know About
Crown lengthening is a common, routine gum procedure, but it has trade-offs. The treated tooth looks longer, and if roots are exposed it can be sensitive to cold for a while. Small dark spaces can appear between teeth where gum used to fill the gap. Removing bone also takes away a little of the support around the tooth, which is why the amount is planned from X-rays first. Bleeding and infection are possible after any gum procedure, so call if healing does not feel right.
What Crown Lengthening Costs
The cost of crown lengthening depends on how many teeth are treated, whether bone needs reshaping as well as gum, and whether it is part of a larger plan that includes crowns or veneers. Ask for an estimate after your exam so you know the number before treatment starts.
Insurance often treats the two uses differently. When crown lengthening is needed so a damaged tooth can be restored, many dental plans cover part of it as a periodontal procedure, subject to your deductible and annual maximum. When it is done only to change how a smile looks, coverage is often limited or not available. We accept PPO plans; ask us how your plan applies to your treatment. For the remaining balance, we offer payment plans through Cherry, CareCredit and LendingClub, plus an in-office plan for patients without insurance.
Frequently Asked Questions
Is crown lengthening worth it?
Crown lengthening is often worth it when it lets a damaged tooth be saved with a crown that seals properly and keeps the gum healthy. For a gummy smile, it is worth it when extra gum tissue is the cause. It is less useful when the tooth is broken too deep to support a crown, or when the smile issue comes from the lip or jaw.
How painful is a crown lengthening procedure?
Crown lengthening is done with the area numbed, so most people feel pressure rather than pain during the procedure. Afterward the gums are usually sore and a little swollen for a few days. Over-the-counter pain relievers and a cold pack are often enough, and you can ask about sedation if you are nervous about dental work.
Is crown lengthening risky?
Crown lengthening is a routine gum procedure, and serious problems are uncommon. The usual trade-offs are teeth that look longer, temporary sensitivity to cold, and small gaps between teeth where gum used to be. Taking away bone also reduces some of the tooth’s support, so the amount is planned from X-rays before treatment.
Do your gums grow back after crown lengthening?
Gums do not grow back to where they were after crown lengthening, but they can creep back slightly while they heal. That is one reason the final crown is placed only after the gumline has settled. When bone is reshaped as part of the procedure, the new gum level is usually more stable.
Is crown lengthening covered by insurance?
Insurance often covers part of crown lengthening when it is needed to restore a damaged tooth, because most plans treat it as a periodontal procedure. When it is done only for appearance, coverage is often limited. Your deductible and annual maximum still apply, so ask how your plan applies before treatment.
Can a regular dentist do crown lengthening?
Some general dentists perform crown lengthening, especially simpler cases that involve only gum tissue. Cases that need bone reshaping or involve several front teeth are more often done by a periodontist, a dentist with additional training in the gums and bone. Ask us how your case would be handled before you decide.
How common is crown lengthening?
Crown lengthening is a common procedure in restorative dentistry. It is often recommended for teeth broken near the gumline, teeth with decay under old fillings, and teeth that have lost structure after a root canal. Cosmetic crown lengthening for a gummy smile is less common but well established.
Book a Crown Lengthening Consultation in Redondo Beach
Redondo Beach Dental Group is at 2511 Artesia Blvd, Redondo Beach, CA 90278. We are open Monday 7:30 a.m. to 5:30 p.m., Tuesday 8:30 a.m. to 5:30 p.m., and Wednesday through Friday 7:30 a.m. to 5:30 p.m. Call (310) 542-6988 or request an appointment online, and bring any X-rays or notes from your dentist.