Crown Lengthening

What Is Crown Lengthening?

Types of Crown Lengthening

Restorative Crown Lengthening
Restorative crown lengthening is typically a necessary procedure performed to properly restore a tooth. It is recommended when there is insufficient healthy tooth structure above the gum line to support a filling or crown, or when deep decay or a fracture extends beneath the gum tissue.

Cosmetic Crown Lengthening
Cosmetic crown lengthening is an elective procedure performed solely to improve the appearance of the smile. Some people naturally have excess gum tissue that makes their teeth appear short, square, or uneven. 

Common Reasons for Crown Lengthening

Deep decay below the gum line
 It is not uncommon for untreated tooth decay to spread not only deeper into the tooth but also beneath the gum line. When decay extends too close to the jawbone, it may not be possible to maintain the necessary space for healthy gum tissue. In these cases, crown lengthening may be recommended to establish the proper biologic width. Not every patient responds the same way when this space is compromised. Some individuals develop chronic inflammation, bleeding, and gum discomfort, while others may have few or no symptoms. In select cases, the area can be monitored if the gum tissue remains healthy and stable.

Inability to properly isolate and restore the tooth
For a filling or crown to be successful, the tooth must be clearly visible and kept completely dry during the procedure. When the margin of a prepared tooth extends too far beneath the gum line, it becomes difficult to see and, in most cases, impossible to properly isolate from saliva and blood. Without adequate isolation, it is challenging to impossible to proceed. In these situations, crown lengthening is often recommended to expose additional healthy tooth structure above the gum line. This allows the dentist to properly isolate the tooth, accurately fit the restoration and improve its long-term success. If the patient declines crown lengthening, extraction may be the only remaining treatment option.

A fractured or broken tooth 
A tooth that has fractured below the gum line can present many of the same challenges as deep decay. If the fracture extends beneath the gum tissue but remains above the level of the supporting jawbone, crown lengthening may be recommended to expose enough healthy tooth structure for a predictable restoration. One of the primary reasons dentists recommend crowns for weakened teeth, such as those with very large fillings or following root canal treatment, is to reduce the risk of future fractures. By covering and reinforcing the remaining tooth structure, a crown can significantly improve the tooth’s strength and long-term prognosis.

Insufficient tooth structure
For a dental crown to be successful, there must be enough healthy tooth structure above the gum line to securely support and retain the restoration. When a tooth has been severely worn down, fractured, or extensively damaged by decay, there may not be sufficient height remaining to properly hold a crown. In these situations, crown lengthening can expose additional healthy tooth structure. This creates more surface area for the crown which improves its retention and significantly increases the long-term prognosis of the restoration.

A “Gummy Smile”
Some people have excess gum tissue covering otherwise healthy teeth, making the teeth appear shorter and more square than they actually are. This condition, commonly referred to as a “gummy smile,” may occur naturally or develop as a result of altered tooth eruption, orthodontic treatment, or teeth that are not in their ideal position.

Cosmetic crown lengthening
This can improve the appearance of a gummy smile by carefully reshaping the gum tissue to expose more of the natural tooth surface. This creates a more balanced gum line, makes the teeth appear longer and more proportionate, and greatly enhances the overall appearance of the smile.

Uneven gum contours
Unlike a gummy smile, which affects multiple teeth, an uneven gum line may involve only a single front tooth yet still affect the appearance and symmetry of the entire smile. Cosmetic crown lengthening can correct this condition very predictably.

Existing unresolving gum inflammation
If you have an existing filling or crown and the gum around the tooth is constantly irritated, slightly swollen, or bleeds easily despite good brushing and flossing, there is a good chance that the margin of the filling or crown is the cause. Crown lengthening can often resolve this problem by creating the proper biologic width, allowing the gum tissue to heal and remain healthy.

What Happens During Crown Lengthening?

Recovery After Crown Lengthening

Schedule a Crown Lengthening Consultation

If you have a tooth that is broken below the gum line, extensive decay, or are unhappy with the appearance of a gummy smile, crown lengthening may be the ideal solution. We will evaluate your oral health, discuss your treatment options, and create a personalized plan to help restore your smile.

Frequently Asked Questions

Is Crown Lengthening Painful?

The procedure itself is performed using local anesthesia, so you should not feel pain during treatment. Mild soreness or sensitivity afterward is common and generally resolves within a few days.

Will my teeth look longer?

Yes. Crown lengthening exposes more of the natural tooth, making the teeth appear longer and creating a more balanced smile.

Will the gums grow back?

The gums heal into their new position. Once healing is complete, the results are generally long-lasting when good oral hygiene is maintained.

How Long Before My Permanent Crown Is Placed?

In many cases, you must wait approximately 8 weeks before a final impression can be taken. This healing period allows the gum tissue to fully stabilize, ensuring an accurate impression and an ideal fit for the final crown.

Is Crown Lengthening Covered by Insurance?

Coverage depends on your dental insurance plan and whether the procedure is performed for restorative or cosmetic purposes. They are almost never covered for cosmetic purposes. Our office will help review your benefits before treatment.

Learn More

The American Academy of Periodontology provides reliable patient education about periodontal procedures, including crown lengthening.