Crown Lengthening: When More Tooth Needs to Be Exposed

Crown lengthening is a procedure that exposes more of a tooth's natural structure, either by removing excess gum tissue alone, or by removing both gum tissue and a small amount of underlying bone, depending on what your specific case requires.

Gum contouring, in its purest form, addresses soft tissue only — reshaping the gum line without touching bone. Crown lengthening is a broader term that can include gum tissue removal alone for purely cosmetic cases, or gum tissue plus bone removal when more significant exposure is needed, often for a functional rather than purely cosmetic reason.

Common reasons include preparing a tooth for a crown or filling when there isn't enough exposed, healthy tooth structure above the gumline for the restoration to properly attach to, correcting a "gummy smile" for cosmetic reasons, and addressing a tooth that fractured at or below the gumline, where more of the tooth needs to be exposed before it can be properly restored.

Functional crown lengthening is done to enable proper restorative treatment, such as placing a crown on a tooth that doesn't otherwise have enough exposed structure. Cosmetic crown lengthening addresses the appearance of a gummy smile, exposing more tooth purely for aesthetic reasons rather than to prepare for a specific restoration.

No, this depends on your specific case. If simply removing excess gum tissue provides adequate exposure, bone isn't touched. If your case requires exposing more tooth structure than gum removal alone can achieve, a small amount of underlying bone is also reshaped as part of the procedure.

Performed under local anesthesia, your dentist or periodontist removes the necessary gum tissue, and if needed, reshapes a small amount of underlying bone, to expose the appropriate amount of tooth structure for your specific goal, whether that's cosmetic improvement or preparation for a restoration.

Recovery generally involves some swelling and soreness for several days to about a week, somewhat more involved if bone was reshaped as part of the procedure compared to gum tissue removal alone, with your dentist providing specific aftercare instructions based on the extent of your particular procedure.

If crown lengthening was performed to prepare for a crown or other restoration, your dentist typically allows a healing period, often several weeks to a couple of months, before proceeding with the final restoration, ensuring the gum tissue and, if applicable, bone have adequately healed and stabilized first.

The procedure is performed under local anesthesia, and while some post-procedure soreness is expected, particularly if bone was involved, most patients describe it as manageable with appropriate pain relief during the healing period.

Cost varies based on whether bone removal is involved, how many teeth are affected, and whether the procedure is being done for functional restorative preparation versus purely cosmetic reasons, which can also affect insurance coverage, since functional crown lengthening is more likely to have at least partial coverage than a purely cosmetic version.