Sometimes, in order to have a dental procedure, additional preliminary treatment may be needed. Crown lengthening is a procedure that you might need before a dental restoration. If you don’t undergo the procedure, the artificial teeth can come off. There’s also the risk of damage to the gum tissues.
You should know that even though crown lengthening seems like a simple enough procedure, improper technique can result in poor aesthetic results. It can even cause other oral health problems. Therefore, the choice of dentist is important. Usually, this procedure is performed by a periodontist.
What Is Crown Lengthening?
Crown lengthening is a dental procedure which exposes more of the tooth structure beneath the gum tissue. The crown refers to the portion of the tooth that’s visible below the gum line. More of it is exposed as a result of this procedure, hence the name crown lengthening.
It becomes necessary if a dental restoration, such as a crown, has to be placed on top of the existing tooth. That’s because a dental crown must be supported by some existing tooth structure. It is going to be cemented on that. In the absence of enough of it, the crown will fall off.
If the dentist tries to embed the crown deep into the gum tissue (without exposing more of the tooth for support), you can end up with inflammation of the gum tissue. You also won’t be able to clean plaque from the portion of the crown underneath the gum tissue. It may even lead to the degradation of the alveolar bone in the long run.
Therefore, crown lengthening surgery is necessary in many cases. As soon as you have healed from your crown lengthening procedure, impressions and measurements will be taken for your permanent crowns.
What Is The Purpose Of Crown Lengthening?
A crown lengthening procedure may be recommended for the following reasons:
Cavity Below The Gums
A cavity below the gum line can be seen through an X-ray. However, it is not possible for the dentist to access it without pushing the gum tissue back. For this, both the gum and tissue are going to be readjusted so that the cavity is visible below the gum line. Following that, the cavity can be treated. If it remains untreated, the cavity can damage the deeper layers of the teeth. It can even result in the loss of a tooth.
Deep Tooth Fractures
If you have a deep tooth fracture and it is possible to save the existing tooth structure, your dentist might recommend a crown lengthening procedure. By peeling the gum tissue and bone away, the dentist will expose the broken part of the tooth. Once that happens, the tooth will be prepared for a dental crown. This allows for a more conservative approach as the dentist isn’t extracting the entire structure of the natural tooth.
Crown Placement
If you need dental crowns for chips, cracks, gaps, stains or misalignment of your teeth, your existing teeth will have to be prepped. However, if your teeth are quite short because of too much gum tissue, the crown might not fit properly. In that case, you can benefit from a crown lengthening procedure. Keep in mind that if you place a crown over a tooth that’s too far receded towards the gums due to decay or fracture, it will fall off. So, you will need to have the crowns of your teeth lengthened for better results.
Wear & Tear
Excessive wear and tear of the teeth can result in loss of significant tooth structure. You’ll end up with very short teeth. This can happen if you have a teeth-grinding disorder known as bruxism. In this case, too, a crown lengthening procedure can help restore the original height of your teeth.
What Are The Contraindications For Crown Lengthening?
A crown lengthening surgery is contraindicated in the following instances:
- Your tooth is significantly damaged and cannot be retained.
- You have poor oral hygiene, and you smoke.
- The root of the tooth is too close, so it has the potential to be damaged.
- The procedure has the potential to damage the surrounding teeth.
An alternative treatment plan may involve extraction and implant placement if you are not suitable for crown lengthening.
What Is The Procedure For Crown Lengthening?
Your dentist will perform a physical exam, take an X-ray and ask for your medical history before performing the treatment. They also need to make different anatomical considerations to perform the surgery successfully; some of these include:
- Lip line (the bottom portion of the upper lip)
- The branching point of the tooth root and its structure
- The size of the alveolar bone between adjacent teeth
An experienced surgeon will make sure to look out for these to not cause any lasting damage to the natural teeth. Sometimes, you may be recommended a dental cleaning before the crown lengthening takes place. This can help reduce the risk of infection.
When crown lengthening is being performed, first, local anaesthesia will be administered so that you won’t feel any pain. Once it takes effect (which usually takes about 10 minutes), the dentist will cut into the gum tissue using a scalpel, laser, electro- or radiosurgery tool. After that, the gums are peeled back to reveal the underlying structures.
Here, it may be necessary for the dentist to drill away some of the bone so that the tooth structure is visible. Following this, the practitioner will suture the surgical area using non-dissolvable stitches. Now, the gum tissue and the bone will be further back than they were before.
A crown lengthening procedure can take anywhere from 30 minutes to 1 hour. However, it can depend on the number of teeth that are undergoing this treatment. Some patients might need it for their entire upper and/or lower jaw. If it’s only a cavity of one or two teeth, it won’t take long.
What Are The Risks & Side Effects Of Crown Lengthening?
You may experience the following after having this dental procedure:
- Pain
- Discomfort
- Swelling
- Bleeding
- Bruising
- Sensitivity
- Numbness
There’s a risk of infection after the surgery. Other than that, there’s also the risk of the formation of black triangles between teeth because of the recession of the gums. If they’re not too large, it is possible for them to be filled back by gum tissue. Keep in mind that even after the surgery, your gum tissue can grow back.
Also, if only one or a few more teeth were treated, the surgery might make them look larger than the surrounding teeth (since their height has increased), which can be aesthetically displeasing. This can, however, be fixed. Lastly, there’s a risk of the tooth becoming loose in its socket. Consequently, it can fall out, but that’s rare.
What Is The Recovery After Crown Lengthening?
After a crown lengthening, you may be advised to rest for 2-3 days. The stitches in your mouth will dissolve and may take up to a week to be absorbed by your body.
Here, it should be noted that if you had the surgery in preparation for permanent dental crowns, you may need to wait for 3-6 months for the gum tissue to heal.
What Is The Aftercare Of Crown Lengthening?
To make sure that your recovery progresses smoothly, make sure to follow the aftercare instructions of your dentist. Take the medicines prescribed to you, and make sure to maintain good oral hygiene. You may be advised against brushing your teeth 1 day after the surgery, but make sure to ask your dentist. In any case, use a toothbrush that has soft bristles.
Additionally, you may have to stick to a soft diet for a week or so. Avoid anything that’s hard, crunchy or sticky (like carrots, nuts, hard candies). Also, do not apply pressure on the surgical site by poking it or using any straws. You can apply a cold compress on the face to help relieve the swelling (do not put it directly on the surgical area). You’ll also be advised against smoking as it will constrict your blood vessels and delay healing. Alcohol is another thing that you need to refrain from.
What Is The Cost Of Crown Lengthening?
In the UK, crown lengthening may be offered in Band 2 of the NHS. That will cost £65.20. However, you will need additional procedures like fillings (also £65.20) or dental veneers/crowns, which fall in Band 3 and cost £282.80.
So, you can expect to pay anywhere between £400-500. It can be more expensive if you need multiple crowns. Also, keep in mind that the waiting time for NHS dental may stretch to years, which can further complicate matters. And if you get treated privately in the UK, the surgery alone can cost you £600 (a single crown being £400). Instead, you can consider the cheaper and more readily available option of medical tourism. In Turkey, a single crown will cost you £200.
Concluding Remarks
Crown lengthening is a dental procedure that is needed if the existing tooth structure needs to be saved. Otherwise, your entire tooth will have to be extracted, and you’d end up needing implants. The surgery itself is fairly simple, but you need to find an experienced dentist.
Other than that, make sure to follow the aftercare instructions of your dentist to heal as quickly as possible. After that, you’ll be able to get your permanent dental crowns. If they’re too expensive in your home country, you can get those in Turkey.