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A crown is an effective way to save a tooth and restore its form and function. These life-like “caps” that fit over and are permanently attached to teeth have been used for decades with good results.
For this type of restoration to be effective, though, there must be enough of the natural tooth remaining above the gum line for the crown to “grab on to.” This poses a problem if the tooth has broken or decayed too close to the gum tissue.
Fortunately, there is a way to expose more of the remaining tooth for applying a crown. Known as crown lengthening, this surgical procedure is also used for “gummy” smiles, where normal tooth length is obscured by excess gum tissue that makes the teeth appear shorter.
We begin the procedure by first numbing the tooth and gum area with a local anesthetic. We then make tiny incisions inside the gum line on both the tongue and cheek side of the tooth to create a small flap. With this area below the gum line now open to view, we then determine whether we need to remove excess gum tissue or a small amount of bone around the tooth to expose more of the tooth itself. We then position the opened gum tissue against the bone and tooth at the appropriate height to create an aesthetic result.
You shouldn’t experience any discomfort during the procedure, which usually takes about sixty minutes for a single tooth area (which needs to involve at least three teeth for proper blending of the tissues). The pressures and vibrations from equipment, as well as any post-procedure discomfort, are similar to what you would encounter with a tooth filling. After the gum tissue has healed (about six to eight weeks), we are then able to fit and attach a crown onto the extended area.
Crown lengthening a small area may result in an uneven appearance if you’re dealing within the aesthetic zone. One option in this case is to consider undergoing orthodontic treatment first to correct the potential discrepancy that may result from surgery. After orthodontics, we can perform crown lengthening on just the affected tooth and still achieve an even smile.
Crown lengthening is just one of many tools we have to achieve tooth restorations for difficult situations. Using this technique, we can increase your chances of achieving both renewed tooth function and a more beautiful smile.
If you would like more information on crown lengthening, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Saving Broken Teeth.”