What is the Crown Lengthening Procedure?
Crown lengthening is a surgical dental procedure that involves reshaping or removing gum tissue (and sometimes bone) to expose more of a tooth’s structure, particularly the portion hidden underneath the gumline. The procedure is considered routine and is frequently recommended when a tooth does not have enough exposed surface to support a reliable restoration.
While crown lengthening is often associated with cosmetic enhancement, such as the improvement of a “gummy” smile, the procedure is actually most commonly used to support restorative work—for instance, exposing more surface area to a tooth that otherwise would not have enough available structure to secure a crown, filling, or bridge.
Your individual treatment plan will depend on a variety of factors, including the location of the tooth, the health of surrounding tissue, and the goal (whether functional or cosmetic) of the procedure.
Preparation & Procedure
Before the crown lengthening procedure begins, your caregiver will start with a clinical evaluation, including X-rays and periodontal probing. Your dentist or periodontist will assess how much of the tooth is currently exposed, how much additional exposure is needed, and whether bone removal will be necessary to achieve a healthy, stable result.
On the day of the crown lengthening procedure, local anesthesia is used to numb the treatment area. In a basic case, the dentist will make small incisions in the gum tissue to gently pull it away from the teeth. This allows for better access to the root and underlying bone. If bone reshaping is required, the dentist will remove small amounts of alveolar bone to lengthen the clinical crown—the portion of the tooth that is visible above the gum.
Once the necessary adjustments are made, the gum tissue is repositioned and sutured into place. A periodontal dressing or protective gauze may be applied to support the healing process. The entire procedure usually takes between 30 and 90 minutes, depending on how many teeth are involved and how complex the anatomical structures are.
Recovery and Post-Op Care
The crown lengthening procedure is generally well tolerated. Post-operative discomfort is typically mild and can be managed with over-the-counter anti-inflammatory medications, though stronger options may be prescribed in certain cases. Ice packs may be recommended for the first 24 hours to reduce swelling. Patients are advised to avoid brushing near the site for the first few days and to follow a soft food diet during early healing.
Healing from the procedure occurs in stages. Soft tissue typically begins to recover within a week, though full stabilization of the gumline can take up to two to three months. If the procedure is performed to prepare for a crown or veneer, the dentist may wait until the gum tissue has fully settled before completing the final restoration. This ensures that the margins of the crown align properly with the reshaped gumline and do not become exposed or inflamed over time.
Crown lengthening is a predictable procedure when properly planned and performed. It allows for better-fitting crowns and restorations, reduces the risk of future decay beneath the gumline, and, in some cases, enhances the aesthetic proportion of a smile. While not everyone is a candidate, it is often the most effective way to preserve a compromised tooth without extraction. By carefully recontouring the relationship between the gumline and the tooth, the crown lengthening procedure provides the structural and biological foundation needed for successful long-term dental care.