Crown Lengthening: Cost, Recovery Time & What to Expect

Crown lengthening helps your dentist attach a crown to a tooth that may not have enough surface otherwise. Some gum, bone, or both are removed to allow your dentist to expose more tooth as an attachment surface.

What Is Crown Lengthening?

Millions of American adults have crowns over their teeth, and many of those require crown lengthening. This procedure uses parts of the tooth that are lower to the gums, or below the gums, to secure the crown in place when there is not enough tooth surface to attach the crown otherwise.

A dental crown is an important appliance used to protect and support teeth that could be damaged for any reason. For example, if much of a tooth was lost due to tooth decay, the remaining tooth might not be enough to support the filling. A crown helps to contain and support the filling and protect your root.

Crowns can also help to restore broken teeth, cover discolored teeth, or become part of a replacement tooth when attached to a dental implant. A dentist may attach a dental bridge to a crown as well.

There are several reasons for crown lengthening, which can help restore your dental health.

Crown Lengthening & Dental Crown Placement

Crown lengthening does not involve changing the size of the crown your dentist will use. Instead, it removes some of the gum tissue, bone, or both to expose more of the tooth that needs to be covered. This allows your dentist to use this tooth surface to attach the crown and protect your root.

Common reasons for crown lengthening include:

• The damaged tooth broke at the gum line.

• The gumline is too far along the tooth for restorative treatment.

• There is not enough tooth remaining.

• A previous crown or filling has fallen off, exposing decay underneath.

Even if the thought of removing some of your gum tissue seems concerning, this is a common procedure for many people simply because of genetics.

The terms “gummy smile” and “short teeth” refer to how much of a person’s gum line you can see when they smile. Some people, who naturally have more gum tissue covering their teeth, may appear to have smaller or shorter teeth as a result, and will show more gum tissue when they smile.

This is very normal, but in instances where someone with a gummy smile struggles with a damaged or decayed tooth, their dentist is more likely to need to perform a crown lengthening procedure. Some people may also opt for the crown lengthening procedure for cosmetic reasons.

What to Expect From a Crown Lengthening Procedure

There are three types of crown lengthening.

1. Gingivectomy: This is the removal of gum tissue using a scalpel or laser, with local anesthesia. This is most often performed for cosmetic reasons.

2. Apically repositioned flap surgery: This procedure involves an incision in the gums to create a flap of tissue, which the periodontist lifts to remove excess tissue, and possibly bone, underneath. The flap is then situated toward the root of the tooth and stitched into place so the gum can heal.

3. Surgical extrusion: This is a removal of some gum tissue and repositioning the tooth so it sits correctly in relation to the gumline. This is most likely to occur when a tooth has been fractured. The periodontist may use a wire or splint to attach the tooth to surrounding teeth as the gums heal and stitches dissolve.

Before your crown lengthening procedure, you will meet with your periodontist and dental hygienist. Your mouth will be thoroughly cleaned to reduce the risk of infection from plaque or tartar. Your dentist will then apply local anesthetic so you are not in pain during the procedure, but you may feel discomfort, pressure, or mild pain as the anesthetic wears off.

Typically, you can take over-the-counter pain medications like ibuprofen or acetaminophen to manage pain for the first few days after the procedure. Your dentist may also recommend a cold compress to ease swelling.

If your dentist performs this procedure because you have a damaged tooth, they will put a temporary crown over the tooth to protect it as the permanent crown is created. This temporary fitting also helps your dentist ensure there is enough tooth after the crown lengthening procedure to support a final crown and the tissue can safely handle the dental appliance.

The crown you receive may be made from:

• Porcelain bonded to metal, which uses metal as a base with porcelain on top to look like a natural tooth.

• Porcelain, which is typically used for front teeth and may not be as strong as metal bonded crowns.

• Ceramic, which is as strong as porcelain bonded to metal but looks like a natural tooth and is suitable for replacing front or back teeth.

• Glass, another strong material that is suitable for any part of the mouth.

• Gold alloy, which may appear silver or gold and has no natural-looking coating over it, so it is typically used for back teeth.

After the Crown Lengthening Procedure

Healing time depends on where the procedure is performed in the mouth. Full healing may take between 6 and 12 weeks in the back of the mouth, while healing in the front can take as long as 3 to 6 months. This includes waiting for stitches to dissolve or be removed, getting fitted for the permanent crown or bridge, and waiting for gum tissue to be fully healed.3

You may experience pain for up to a week after the initial gum removal, but that should fade.1 Ask your dentist if you continue to experience:

• Inflammation and tenderness in the gums.

• Pain that does not go away or gets worse.

• Bleeding that does not stop.

• Gums or cheeks feeling hot.

• Other signs of infection.

Cost of Crown Lengthening

The cost associated with crown lengthening depends on several factors, starting with whether you need the procedure for medical reasons or if you opt for crown lengthening for cosmetic reasons. If this is part of restorative dental treatment, your dental insurance may cover part of the cost.

Price estimates range from $1,000 to $3,000, depending on the cost of living in your area, what your dentist normally charges, how the crown is made, and how many teeth need a crown during the implant procedure. One estimate suggests that crown lengthening starts at $50 per tooth, but notes that the procedure, even for medical reasons, rarely requires gum removal around just one tooth.

Crown Lengthening Is an Important Procedure for Oral Health

Crown lengthening might sound like an exotic dental procedure, but it is nearly as common as receiving a dental crown. If you suffered from an injury that damaged a tooth, tooth decay has caused the loss of most of a tooth, or your dentist otherwise needs to protect one of your teeth, they may recommend putting a crown over the area to restore your oral health. Some people also opt for crown lengthening as a cosmetic procedure, so they have a less “gummy” smile.

Although recovery may take months, pain should not last for more than a week. You will be able to add certain foods back into your diet as your gum heals and the dental crown settles into place.