Crown Lengthening
Crown lengthening is performed on teeth that have to be fixed. There are times where not enough tooth sticks out above the gum. There must be enough tooth to support a filling or a crown. Not enough tooth sticks out when a tooth breaks of at the gum line or when a crown or filling falls of a tooth with decay underneath. In this case, your dentist needs to expose more of the tooth. This is done by removing gum tissue or bone. Some people have a lot of gum tissue on their upper teeth. This is also known as the gummy smile. It can also be treated with crown lengthening.
How do you prepare for crown lengthening?
Before crown lengthening is performed, you have to visit a periodontist. During this visit, the periodontist will review your medical history and your X-rays. The date of your surgery will also be set. You may also have to go through professional tooth cleaning before you go through the surgery.
If a tooth needs a crown then your periodontist may put a temporary crown at first. This will protect the tooth and make it much easier for the surgeon to see how much soft tissue or bone has to be removed.
The area will heal in around three months and then your dentist will prepare the tooth once more. A new temporary crown will be fit for the lengthened tooth and then the final crown will be made.
How is crown lengthening done?
Local anaesthesia will be used during a crown lengthening procedure. The length of the operation will depend on the number of teeth that have to be treated. Even if only one tooth is involved, crown lengthening usually involves the neighbouring teeth as well. This will allow the tissues to be reshaped slowly. If both the bone and the soft tissue are removed then the procedure will take longer than usual.
The periodontist will make cuts that will pull the gum away from the teeth and expose the roots and surrounding bone. In some cases, only a little gum tissue has to be removed and it will already expose enough of the tooth for the crown to be placed. In most cases though, the periodontist may have to remove some bone from around the roots of the teeth. After the periodontist has exposed enough tooth, the surgical area will be washed with sterilized water and the gums will be stitched back together. Some dentists will even put a bandage over the stitches.
If there are temporary crowns on any of the involved teeth then they will be removed before the procedure. They will be put back after the procedure.
You will be given prescription painkillers and mouth rinse for proper oral care after the surgery. You may have to follow a soft diet as well. You can brush the teeth near the stitches but you should avoid the gums. You can remove food particles with a toothpick or with a water irrigator.
What should you do after the crown lengthening procedure?
For the first two days, you can ice your face in order to reduce the swelling. You must return to the periodontist after a week or two in order to have the stitches removed. You may also need to go back for a follow-up visit after one month.
Your gums should heal completely after three months. Gums will shrink as they heal so if you don't wait long enough, the edges of the crown may be exposed. Be patient and have the crowns installed when your gums are healed enough. Your regular dentist will be the one to put the crown or the filling.
What are the risks associated with crown lengthening?
You will experience bleeding after the procedure. There is a risk of infection after the surgery and a risk for complications as well. People will notice that their teeth are extra sensitive after the surgery. This is due to the fact that the roots of the teeth are now exposed. The sensitivity will go away in time or it will go away when the crown is put on your tooth.
Because of tissue and bone removal, the affected tooth may look longer than the teeth beside it. Removing bone from around a tooth may make it loose. If that tooth is lost, it could be harder to place a dental implant and replace it. You should discuss these possibilities with your periodontist.
When should you call a professional?
You must contact your periodontist if
- the bleeding refuses to stop
- the painkillers are not helping
- you think that the area is infected
- there is a lot of swelling and discharge in the area
- the bandage loosens up or falls off
- there are tender lumps beneath your lower jaw or in your neck