You may be embarrassed to smile fully if you have a gummy smile, but a cosmetic crown lengthening procedure can help to create a more attractive smile. At Baltimore Periodontics Lasers & Dental Implants, we are able to restore your confidence by performing teeth lengthening to reveal more of the tooth for not only a greater cosmetic appeal, but it can also help for more restorative dentistry procedures.
What is Crown Lengthening?
Crown lengthening also known as teeth lengthening is a procedure that allows for the exposure of more tooth structure in comparison to the gums. The reshaping of the gums for a desired tooth, or multiple teeth can lead to the adjustment of the newly exposed bone level. There are many dental conditions that may require crown lengthening as part of the restorative procedure. These procedures include, but are not limited to the support for a filing or a new dental crown. Within our Catonsville office, Dr. Moskowitz will discuss with you an individualized plan to insure the results you are looking for.
What is a Gummy Smile?
A gummy smile occurs when there is an excess amount of gum tissue and bone covering the surface of the tooth. This can make your teeth appear much shorter and asymmetrical. Some patients feel self conscious about their smile and desire periodontal plastic surgery to help remove and reshape the gums and bone for a more attractive appearance.
Who is a Good Candidate for Crown Lengthening?
Crown lengthening serves both restorative and cosmetic purposes. A gummy smile is often the reason for this procedure, however there are many dental conditions that can lead to the necessity of this procedure. Some reasons include the following:
- Severe tooth decay, where the decay extends below the gum line.
- Inadequate tooth length due to wear
- Tooth fractures that occur beneath the gum line.
- Cosmetic work to enhance the placement for veneers, crowns, or bridges.
When is crown lengthening necessary?
Crown lengthening is only “necessary” for restorative purposes. These include cases where a tooth has been worn down, possibly by nighttime grinding, and not enough of the tooth is above the gumline to support a filling or a crown. This is also the case if a tooth breaks at or just above the gumline. Sometimes a crown or filling will fall off/out of a tooth, and it turns out there is decay underneath. More tooth surface is needed to be able to place the crown or the filling.
These are cases when crown lengthening is truly necessary. But for people with gummy smiles, meaning they have an excessive amount of gum tissue around their upper teeth, while this could be classified as a cosmetic treatment, for the patient’s confidence in his or her smile it could be “necessary.” Crown lengthening in these cases beautifies the smile by exposing more of the crown (the visible portion) of the tooth and reducing the gum presence.
Crown Lengthening Procedure
Dr. Moskowitz typically performs these procedures with the patient under local anesthesia. The goal varies between patients: in some cases removing gum tissue will be all that is required, but in others bone will also need to be removed.
Dr. Moskowitz makes cuts that pull the gums away from the teeth. This exposes the roots of the teeth and the surrounding bone. With gummy smiles, usually simply removing gum tissue can be sufficient. But most of the time for restorative cases, Dr. Moskowitz will need to remove some bone from around the roots of the teeth. When enough of the tooth has been exposed, the area is washed with sterile water and the gums are stitched back together.
For simply removing gum tissue, Dr. Moskowitz may be able to use only a diode laser, which makes a dramatically easier recovery.
How long will healing take after crown lengthening?
Crown lengthening patients return to our offices in 7-10 days and we remove their stitches. We’ll need to see you again in 4-6 weeks for a follow-up. Your gums will need to heal for about three months before they are ready for the crown or other necessary treatment.
What will my recovery be like?
The full healing cycle, as mentioned above, is about three months. But that’s to prepare for the restoration. Otherwise, patients can return to normal activity as their gums heal. Strenuous activity only needs to be avoided for 2-3 days because the increased blood pressure to the face can cause more bleeding.
For pain, you may only need ibuprofen or Tylenol, but we will give you a prescription for pain medication. Using an ice pack for the first few hours you’re home will help with swelling. Follow a 20 minutes on/20 minutes off schedule. After two days of this, you can switch to moist heat for comfort.
No hot foods for 24 hours, and no rinsing of your mouth. These can both extend your bleeding. If bleeding does continue, place a moistened tea bag on the spot and apply light pressure for 20-30 minutes.
Brush gently, only on the biting surfaces above where your dressings are. Elsewhere in your mouth you can brush and floss normally.
You’ll eat a soft diet until your gums heal, but you should also avoid acidic, spicy, sticky, or brittle foods. No nuts or small seeds. Drink plenty of fluids. Avoid alcohol until after your post-op appointment in 7-10 days.
What are the risks involved with crown lengthening?
Your gums may not stop bleeding, at least not in the normal timeframe. Also, infection is always possible with dental procedures. Because more of the tooth root is exposed, and because this part of the tooth is not covered with enamel, patients can have increased sensitivity to hot and cold in these teeth. This passes with time, or when the crown is placed over the tooth.
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