Crown lengthening involves removing gum and bone around a tooth to expose more of the tooth in the mouth. Crown lengthening is done when a tooth needs to be fixed, but not enough tooth is present above the gum to support a crown or a filling. This can happen when a tooth breaks off at the gum line, or a crown or filling falls out of a tooth that has extensive decay underneath. If your dentist wants to repair the tooth using a crown or a large filling, they may need more tooth to be exposed above the gum by removing some gum and bone around the tooth. This will allow them to place a good fitting filling or crown.
In some cases where there is excess gums and the shape of the teeth want to be improved for esthetics (a condition called gummy smile), crown lengthening can also be completed to improve the cosmetics of the smile.
Crown lengthening is done under local anesthesia. Incisions are made to reflect the gums away from the teeth. This provides access to the roots of the teeth and the bone that surrounds them. In some cases, by simply removing a little gum tissue when the incisions are made, enough tooth will be exposed for your dentist to place a crown of filling. However, in most situations it will also be necessary for the periodontist to remove some bone from around the roots of the teeth. The bone is removed using a combination of hand instruments and rotary instruments (similar to the drill and burs used to treat cavities).
The gum tissue is then secured in the new improved position with sutures. At this point, your teeth will look longer because the gums are now sitting at a lower level then before the surgery. Sometimes a periodontal dressing may be used —an intraoral bandage —to cover the surgical site. It helps protect the surgical site, keeps the gums in the ideal position and aids in healing. Any temporary crowns will be removed before the procedure begins and replaced afterward.
Following a prescribed healing period, your dentist can then move forward with any fillings or cosmetic work that is recommended.