Do I Need Crown Lengthening?
Crown lengthening is a surgical dental procedure that adjusts the gumline (and sometimes, the underlying bone) to expose more of a tooth’s surface. The procedure is used in both general and restorative dentistry and plays a key role in certain treatment plans where the tooth’s structure is not fully accessible above the gumline.
Crown lengthening typically requires healthy periodontal conditions. Active gum disease, uncontrolled diabetes, or compromised immune function can complicate healing. In some cases, patients with a thin gingival biotype or limited bone support may require additional procedures, from bone grafting to soft tissue management, either before or after the crown lengthening is performed.
The procedure itself is usually done under local anesthesia in a dental office or periodontal clinic. Healing typically takes several weeks, although the initial discomfort often subsides after a few days. Post-operative care involves standard soft-tissue healing protocols: avoiding trauma to the area, maintaining oral hygiene without aggressive brushing, and following prescribed rinses or medications. In cases where the procedure supports a future crown or veneer, the final restoration is placed only after the gum tissue has stabilized.
Crown Lengthening as a Functional Treatment
While often associated with cosmetic improvements, it is primarily performed for functional reasons. The most common indication for crown lengthening occurs when a tooth has broken close to the gum margin or is severely worn down. In these cases, there may not be enough visible teeth to anchor a crown or other restoration securely. Without sufficient exposure, placing a crown can result in a poor fit, leaving gaps where bacteria can enter, and eventually causing the restoration to fail prematurely. Crown lengthening creates the space needed to ensure better retention and a longer-lasting result.
Another common reason for crown lengthening is to improve access to decay or fractures that extend beneath the gumline. Decay underneath the gumline is difficult to treat effectively without first exposing the affected area. Surgical shaping of the gums (and in some cases the alveolar bone) allows the dentist to remove decayed matter thoroughly and lay the groundwork for a clean, stable restoration.
Cosmetic Reasons for Crown Lengthening
Some patients may also be candidates for crown lengthening as part of cosmetic treatment. This includes those with excessive gingival display, sometimes called a “gummy smile.” In such cases, the teeth may appear shorter than normal because they are partially covered by overgrown or low-positioned gum tissue.
Cosmetic crown lengthening can reshape the gingival contours to reveal more tooth structure, creating a more balanced aesthetic. However, not all cases of visible gum tissue call for intervention. Evaluation by a dentist or periodontist is necessary to determine whether the appearance is due to gum position, tooth eruption patterns, or skeletal structure.
Crown lengthening is considered a routine and predictable treatment when properly planned. It provides functional benefits by enabling better margins for restorations and can support esthetic goals when appropriate. Determining candidacy depends on clinical factors, including the location and condition of the tooth, the health of the surrounding tissues, and the intended outcome of the treatment. Evaluation by a dental professional with experience in surgical periodontal procedures is essential for making that determination.