Often a smile that shows too much gum tissue makes teeth appear too small for your mouth. Most of us have substantial tooth structures. We do not see enough of it to have the full effect on the whole tooth. The exposure of enough tooth structure through bone tissue and gum tissue removal is called crown lengthening.
A well-trained cosmetic dentist can use crown lengthening (also called a gum lift) to beautify your smile by allowing visibility of more of your natural tooth structure. There are other reasons for the use of crown lengthening surgery as well.
What Is Crown Lengthening?
Crown lengthening surgery has many uses in dentistry but has gained increased prominence as a cosmetic procedure (fixing a gummy smile). Crown lengthening can be used to remove bone and gingival tissues from surrounding teeth.
From an esthetic standpoint, the reshaping of an uneven gum line can make teeth appear in alignment with neighboring teeth without the need for orthodontic braces or porcelain veneers. If tooth decay or fractures fall under the gum line, it will be necessary to remove bone to better access. This will ultimately increase support for future dental restorations.
What Does The Crown Lengthening Procedure Involve?
Crown lengthening is considered a simple surgical procedure that often gives dramatic results just by moving the gum line. The procedure is performed using local anesthesia. After the area is properly anesthetized, your dentist will begin to remove the excess gingival soft tissue around your tooth’s surface. For your comfort, local anesthetic can be administered as needed.
Only gum tissue needs to be removed for most crown lengthening procedures. Generally, healing does not even involve the placement of sutures. In some cases, a small amount of bone will need to be removed along with the gingival tissue. Once the tissues are adequately removed, the gingival tissue is sutured back together, allowing for a quick healing process.
Conditions That Require Crown Lengthening
Several dental issues will require a dental crown lengthening.
Common issues include:
- a shortened tooth or teeth
- extensive tooth decay that extends below the gum line
- a tooth that has broken off and fractured beneath the gum line
A dental crown lengthening procedure can reduce the bone level and softer gum tissues to gain better access to restore and save your tooth.
When a damaged tooth is present either from trauma or tooth decay, the remaining healthy tooth area is reduced, affecting the potential for successful tooth restoration. With crown lengthening, Your dentist will expose more of the tooth’s surface, and this will aid in future dental work such as crowns, veneers, or more.
Crown Lengthening Procedure Advantages
One Time Procedure
A significant advantage to dental crown lengthening surgery is that it only needs to be completed once. No, follow-up services are required.
Increased Dental Hygiene Access
With more tooth exposed, the patient can complete dental hygiene easier. With more natural tooth structure exposed, you will have an easier time keeping your teeth clean.
The entire surgery takes roughly 30-60 minutes. Dramatic results will follow initial healing over the next week to 10 days. The gums heal faster than the bone will. If all instructions are followed a full recovery will be achieved.
Crown Lengthening Procedure Disadvantages
As with all surgical procedures, there are risks. Important to note this is strictly an outpatient procedure. These risks include pain (discomfort), swelling, excessive bleeding, and possible oral infection. If you are in good overall health and can maintain good oral hygiene, risks are typically minimized. Be honest about your medical history. Important to follow instructions to prevent infection.
Initial healing of the surgical site is quite fast. Your oral tissues will be looking better in just a few days. The average complete recovery time takes approximately 2-8 weeks. Tissue healing takes just a few weeks, while bone healing can take almost two months.
The financial cost is always a factor. Dental insurance often picks up part of the price if periodontal pockets are present or inadequate tooth structure is present to prepare for a dental crown. Photographs, X-rays, and periodontal charting are usually required for dental insurance pre-authorization. The final dental crown recommendation will probably be for an all porcelain dental crown. This will give the best esthetic appearance. But there may be other dental crown options as well to consider.
Aftercare and Recovery Of Dental Crown Lengthening
The recovery time for the crown lengthening procedure is about three months. However, you will be able to resume normal functions as the healing process continues. You need to avoid strenuous activity for the first two to three days. A physically demanding job could inhibit your healing and cause more bleeding.
Talk to your dentist about your recovery. Below are guidelines to follow:
Take Over-the-counter or prescription medication as prescribed: Your dentist will most likely advise you to take ibuprofen or Tylenol regularly as needed in your aftercare instructions. The doctor may also prescribe antibiotics and prescription pain medications.
Use an ice pack: Use a pack on your face during the first few hours following the procedure can reduce swelling. The use of the ice pack should be 20 minutes on and 20 minutes off. After a few days, you can switch to moist heat.
Avoid hot foods (temperature) for the first 24 hours: If bleeding continues, use a moistened clean gauze or wet tea bag and apply slight pressure to the area for 20-30 minutes. Wise to choose to eat soft foods to protect surgical area.
Avoid Rinsing for 24 hours.
Leave dentist applied dressings in for 7 to 14 days: The dentist may replace the dressing as needed during this period. Typically your dentist will remove once or twice over that period.
Careful brushing: Brush carefully only your biting surfaces where the dressing has been applied. You may floss and brush normally in other areas of the mouth. Try to et food on the opposite side of your mouth from where the procedure took place.
Wear your stent or denture: If wearing a clear stent or upper denture was recommended by your dentist, do not remove it for 24 hours. If bleeding continues, Rinse with a warm salt water mix or a Chlorhexidine rinse without removing the stent or denture. After 24 hours, you may wear as desired.
Eat a soft food diet:
- Avoid the surgical area when you eat.
- Do not eat anything brittle, hard, acidic, spicy, sticky, or highly seasoned.
- Avoid small seeds and nuts.
- Stay hydrated.
Avoid alcoholic beverages: Refrain from drinking until after your follow-up dental appointment.
Stop smoking: Do not smoke for the first 7-10 days or longer.
Avoid poking the area.
Do not use straws and playing with the surgical site with your tongue or finger.
Do not pull down your lip to constantly check the site for healing, as the pressure can cause damage.
Crown Lengthening Procedure Conclusion
Sometimes, a relatively simple procedure like crown lengthening can save you from much more extensive treatment or loss of an otherwise un restorable tooth. It is essential to see a well qualified cosmetic dentist or periodontist to evaluate your smile to see if this crown lengthening treatment is right for you.