Crown lengthening is a dental procedure that reshapes the gum tissue, and sometimes the underlying bone, to expose more of the natural tooth. It’s performed for two reasons: to create enough tooth surface for a restoration like a crown, or to correct a gummy smile by reducing the amount of gum tissue visible when you smile.
Crown lengthening comes up in two situations. Either a tooth is broken or decayed so close to the gumline that there isn’t enough surface left to anchor a crown properly. Or a patient has spent years self-conscious about how much gum shows when they smile. The procedure addresses both.
It’s more common than most patients realize, and the results can be significant in either context.
Key Takeaways
- Crown lengthening exposes more of the tooth by reshaping the gum and, when needed, the underlying bone
- It can be functional (preparing a tooth for a crown) or cosmetic (correcting a gummy smile)
- Performed under local anesthetic, with initial recovery typically taking one to two weeks
- Results are long-lasting when both the gum and bone are properly contoured
Two Reasons It’s Done
Most people who need crown lengthening fall into one of two categories.
Functional crown lengthening is recommended when a tooth has broken or decayed so far below the gumline that there isn’t enough healthy tooth structure above it to secure a crown. Without lengthening first, the crown can’t grip the tooth properly. The procedure exposes enough surface to make a stable, durable restoration possible.
Cosmetic crown lengthening is for patients whose gum tissue covers too much of the tooth’s natural surface, making the teeth look short or causing what’s known as a gummy smile. Technically, showing 3 millimeters or more of gum tissue is considered gummy. Reshaping the gumline reveals the full crown of the tooth and creates better proportions.
While the goals are different, the basic procedure is essentially the same for both.
What the Procedure Involves
Crown lengthening is done under local anesthetic. The area is fully numbed before anything begins. Your dentist makes an incision to lift the gum tissue away from the tooth, exposes the root and the surrounding bone, and removes or reshapes the excess tissue. In most cases, a small amount of bone is also reshaped to establish the right proportions.
That bone reshaping step is what distinguishes crown lengthening from a gingivectomy. A gingivectomy removes only soft gum tissue. When only the soft tissue is removed and the bone isn’t adjusted, the gum often grows back over time. Crown lengthening with bone recontouring produces a more stable, lasting result.
The procedure can be done on a single tooth or across several teeth in the same visit. Sutures close the site, and a follow-up appointment removes them about a week later.
Does Crown Lengthening Hurt?
Crown lengthening is performed under local anesthetic, so you won’t feel pain during the procedure. Mild soreness and swelling are normal for several days after. Over-the-counter pain relievers manage recovery for most patients. Sutures come out in about a week, and the gums typically look and feel normal within a few weeks.
Sedation is available for patients who prefer it. Some temporary sensitivity to hot and cold is normal as the newly exposed portion of the tooth adjusts. This settles as healing progresses.
Recovery and What to Expect
Recovery is generally straightforward. Here’s what the first few weeks typically look like:
- Sutures are removed at a follow-up visit about one week after the procedure
- Mild swelling and soreness are normal for the first few days
- Soft foods are recommended while the area heals
- Sensitivity to hot and cold may persist for a few weeks
- Full gum healing takes several months, though the area looks and feels normal well before that
One important note for patients having functional crown lengthening before a crown: there’s typically a waiting period of 4 to 6 weeks after the procedure before the crown is placed. This gives the gum line time to stabilize so the final restoration fits correctly.
Are There Any Risks?
Crown lengthening is a routine procedure with a low risk of serious complications. The most common side effects are temporary sensitivity and swelling. In some cases, the gum line may not settle exactly as planned, requiring a minor adjustment. Healing is slower in patients who smoke or have underlying health conditions.
For cosmetic cases, one thing to keep in mind is that the final result takes several months to fully reveal itself as the gum tissue settles into its new position. The outcome looks more and more natural as healing progresses.
If you’re bothered by the appearance of your smile or you’ve been told a tooth needs exposure before a restoration can be placed, a smile consultation with Dr. Kitts is the right starting point. Request a smile consultation at our Edmonds office to find out whether crown lengthening is the right approach for you.
