The crown lengthening procedure is used to increase the amount of visible tooth surface, either for cosmetic purposes or restorative ones. While the procedure itself is straightforward, the overall crown lengthening process takes a few visits and a bit of time for preparation and healing. If you’re undergoing crown lengthening to prepare your teeth for a crown or other restoration, the overall treatment process will take longer, as the gums and bone need to heal before restorations can be placed.
The crown lengthening procedure is done in the dentist’s or periodontist’s office, in an outpatient setting. The procedure itself varies in duration, depending on the complexity of treatment and the number of teeth being treated, but in general, it takes around one or two hours from start to finish. Some patients opt for sedation, in addition to local anesthesia; these patients should wait about 24 hours for the sedation to wear off and must secure a ride home from surgery as they plan their treatment. Patients who elect only numbing, local anesthesia can resume most normal activities right away, though they should avoid heavy lifting or exertion for at least 24 hours, and they should wait until all numbness has worn off before eating, to avoid injuring the delicate oral soft tissues. During the procedure itself, your dentist will begin by making an incision in the gums and gently pulling the gum tissue away from the bone and teeth. If the bone needs to be modified to accommodate a crown or filling, the dentist will sculpt and shape the bone at this time. Then, the area is rinsed free of any debris, and the gum tissue is sutured into its new position, creating a new design for the gum line while exposing a larger proportion of the treated tooth.
While the procedure itself is relatively brief, preparation and healing extend the procedure’s overall duration. Preparation includes planning, using X-rays and 3D models; the installation of any temporary restorations, if needed; and treatment of any existing gum disease. It takes a week or two for gum tissue to heal, though it takes longer for underlying tissues to heal and for the gums to fully relax into position; when crown lengthening precedes a restorative procedure, like a crown, the dentist will wait until everything is healed before placing the restoration, usually after around 6 to 8 weeks.
Aftercare instructions always include the following recommendations:
- Avoid using tobacco for at least a week after crown lengthening
- Abstain from drinking alcohol until your follow-up appointment
- Avoid very hot foods or drinks for the first day or two, eat a soft, mild diet for a couple of weeks after your procedure, and avoid small seeds or nuts.
- Don’t rinse your mouth vigorously or spit, as this can disrupt healing and increase bleeding, and make sure to avoid brushing or otherwise irritating your surgical sites
- Don’t disrupt the surgical sites; don’t poke at your sutures or play with them with your tongue, and don’t pull your lip out to look at them
Some pain, swelling, and minor bleeding can be expected during the first few days after crown lengthening surgery. Your dentist will provide guidelines for managing bleeding and pain. Generally speaking, ice packs applied to the outside of the face can help reduce swelling, and eating a diet of soft, mild foods can help minimize irritation to the gum tissue as it heals. Most patients find over-the-counter anti-inflammatory medication sufficient for managing pain. It’s important to maintain good oral hygiene after crown lengthening, though you should avoid brushing the surgical site while the sutures are still fresh. With this in mind, your dentist might prescribe an extra-strength mouth rinse to help you keep your mouth clean while the sutures are still in place as the tissues heal.
After about a week to ten days, you’ll see your dentist again for a follow-up, and they will remove the sutures at this time. If your dentist has used dissolvable stitches, you won’t need to have them removed, but you should still see your dentist for any recommended follow-up visits to ensure smooth, thorough healing. Of course, if you notice anything unusual, like prolonged bleeding, lingering pain, or fever, call your dentist right away, as these might indicate infection. This is rare, however, and in most cases, with proper observation of aftercare instructions, the process of crown lengthening is performed without a hitch, taking a few months from beginning to end to prepare patients for a stellar new smile.
Related Article: Crown Lengthening Pain Healing & Risks