Crown Lengthening Explained: Who Needs It and Why It Matters

Crown lengthening is a transformative periodontal surgery performed primarily by periodontists Cranbook—specialists in gum health. Whether you're preparing for crowns or veneers, correcting a gummy smile, or dealing with decay below the gum line, understanding this procedure is crucial. In Cranbrook and across British Columbia, crown lengthening is an essential step for both functional and aesthetic dental outcomes. Here's a detailed breakdown.

What is Crown Lengthening?

Definition and Overview of the Procedure

Crown lengthening is a surgical procedure designed to expose more of a tooth’s structure by removing gum and sometimes bone tissue. It can be performed on a single tooth or multiple teeth, depending on your needs.

Surgical vs. Laser-Assisted Crown Lengthening

Traditional crown lengthening involves making small incisions, lifting a gum flap, and reshaping tissue and bone. Laser-assisted options offer less bleeding and swelling but may not be suitable when bone removal is necessary.

Why It’s Performed by Periodontists

Periodontists Cranbook bring targeted expertise in managing gum disease, bone structure, and biologic width—the critical zone of gum tissue attachment. Their training ensures both functional and aesthetic success.

When is Crown Lengthening Required?

Clinical vs. Aesthetic Indications

Clinically, crown lengthening may be required for access to deep cavities, fractures, or restorative margins. Aesthetically, it addresses a gummy smile where excessive gum hides your teeth.

Crown Lengthening Before Veneers or Crowns

Restorative work needs at least 3 mm of exposed tooth to support the crown edge and respect biologic width. Without it, restorations can fail due to tension or infection.

Correction of Gummy Smiles

A gummy smile—where gums cover more than 2 mm of tooth length—can be transformed through crown lengthening, revealing a more balanced smile.

Tooth Fracture Below the Gum Line

If a tooth breaks near or below the gum, crown lengthening exposes enough structure to restore it, saving the natural tooth.

Managing Deep Cavities or Decay

Decay beneath the gum line is hard to treat without proper access. Crown lengthening opens the area for thorough cleaning and restoration.

Step-by-Step: The Crown Lengthening Procedure

Initial Consultation and X-rays

Your periodontist, Cranbrook, will conduct a comprehensive exam, take digital radiographs, and assess gum thickness and bone levels. A clear plan—including surgical vs. laser—will be discussed.

Local Anesthesia and Gum Tissue Adjustment

Under local anesthesia, small incisions are made to lift a tissue flap, exposing the tooth and bone.

Bone Reshaping (if required)

To maintain biologic width, underlying bone may be removed or reshaped using burs or chisels. This ensures restorations won’t impinge on tissue.

Suture and Dressing Application

The flap is repositioned and sutured. A protective dressing may be applied to support healing.

Duration and Complexity of the Procedure

Single-tooth surgeries typically take about an hour; multiple teeth or bone removal can extend this. Laser procedures may be quicker but differ in technique.

Recovery After Crown Lengthening

Healing Timeline (7–14 Days for Gum, Months for Bone)

Gum tissue usually heals within 7–14 days, while bone remodels over months. Complete periodontal stabilization may take up to six months.

Post-Op Instructions for Comfort and Healing

Expect swelling and discomfort. Your periodontist will provide guidelines on rest, head elevation, and avoiding pressure on the area.

Pain Management and Inflammation Control

Prescriptions or OTC NSAIDs help manage pain. Cold compresses can reduce swelling.

Eating and Oral Hygiene Tips During Recovery

Stick to soft foods and avoid using straws. Gently brush unaffected areas and rinse with salt water as directed.

When to Resume Dental Work After Surgery

Restorative treatments typically begin after 4–6 weeks. Complex cases may take up to three months to completely heal.

Benefits of Crown Lengthening

Improved Access for Crowns and Veneers

Proper exposure enables secure margins for restorations and minimizes risk of failure.

Long-Term Health of Restorations

By respecting biologic width and enhancing structural support, crown lengthening reduces inflammation and increases longevity.

Enhanced Smile Aesthetics

For gummy smile patients, contouring the gum reveals more tooth structure and harmonizes your smile.

Reduced Risk of Gum Disease

Exposed tooth surfaces are easier to clean, lowering plaque accumulation and periodontal issues.

More Accurate Tooth Structure Exposure

Allows precise shaping and placement of restorations without encroaching on tissue.

Is Crown Lengthening Right for You?

Key Signs You Might Need It

Look for signs like subg‑lining decay, insufficient tooth exposure, or excessive gum coverage affecting appearance.

Patients Preparing for Restorative Work

Those needing crowns or veneers benefit from functional crown lengthening to protect their investment.

Cosmetic Patients Seeking Smile Makeovers

Crown lengthening addresses gummy smiles and asymmetry, significantly boosting aesthetics.

Contraindications and Risks to Consider

Smokers, patients with uncontrolled diabetes, or those with root proximity issues may face complications. Discuss these with your periodontist.

Cost of Crown Lengthening in BC

Factors Affecting Price (Complexity, Number of Teeth)

Complexity, tooth count, and bone involvement are key cost drivers.

Insurance Coverage and Dental Plans

Restorative-driven crown lengthening is more likely to be covered by insurance than purely cosmetic procedures. Policies vary, so check with your provider.

Long-Term Cost Benefits of the Procedure

Avoiding restoration failure, repeat treatments, or extractions can save significant costs in the long run.

Alternatives to Crown Lengthening

Orthodontic Extrusion

This non-surgical option uses braces to reposition the tooth, preserving bone. It takes longer and requires orthodontic compliance.

Cosmetic Bonding (For Minor Cases)

For small irregularities or chip coverage above the gum, composite bonding may be a less invasive option.

Gum Contouring with Lasers

Effective for soft tissue-only reshaping; ideal for mild gummy smiles but does not address bone, risking relapse.

Final Thoughts: Why Expertise Matters in Crown Lengthening

Choose a Board-Certified Periodontist

Their in-depth training in periodontal health ensures precision in managing tissue, bone, and biologic width—essential for long-term success.

Importance of Collaborative Planning with Your Restorative Dentist

Seamless communication between your dentist and periodontist, Cranbook ensures crown margins are placed with precision and allow optimal healing before final restorations.

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