Case Study: Crown Lengthening

Crown Lengthening: Before and After

This woman came to our office with concerns about the appearance of her two front teeth. Her family told her they looked fine but she was unhappy with them. We fixed the two front teeth for her by recontouring the gums around the teeth and replacing the crowns with new metal-free crowns.

Before: Crown Lengthening Pre-Op

teeth before crown lengthening

After: Crown Lengthening Post-Op

teeth after crown lengthening

Crown lengthening is a dental procedure whose main purpose is to reveal more of the tooth’s crown, which is the part of the tooth located at the top of the gum line. A dentist works to expose more of the tooth’s crown by surgically moving the gums closer to the root.

The procedure assists in preventing the trapping of foods, as well as other complications such as restorative dental appliances weakening or falling off the tooth. For those that require dental restoration devices, such as a bridge, crown lengthening adjusts the tooth’s bone level so that the device has enough surface area to be held in place.

When is Crown Lengthening Necessary?

A crown lengthening procedure is necessary in multiple cases. They include:

  • Cosmetic concerns (a “gummy” smile)
  • Decay located beneath the gum line
  • Fractured or broken tooth beneath the gum line
  • Dental device implantation

Cosmetic Concerns

When a patient’s gum line has moved too far down over their teeth, revealing a “gummy” smile, a dentist or periodontist (gum specialist) can assist. Irregular gum levels have a variety of causes, but crown lengthening can even the line. Doing so creates a more symmetrical appearance, as well as improves patient confidence.

Decay Beneath the Gum Line

When tooth decay, such as cavities, are located deep beneath the gum line and cannot be accessed any other way, crown lengthening is necessary. During the procedure, the dentist or periodontist will move the gum to access and treat the decay, then return it to its original position. Thus, the crown lengthening procedure is not permanent. However, doing so will create more tooth structure for the new crown to hold onto, increasing the success rate of a full restoration.

Fractured or Broken Tooth Beneath the Gum Line

As with treating tooth decay, the same practice can be applied to situations where a tooth is fractured or broken beneath the gums. The specialist will move the gums to expose the damaged tooth and repair it, thus saving it from extraction.

Dental Device Implantation

In some cases, dental device implantation requires greater tooth surface area in order to achieve the most successful results. The crown lengthening procedure is performed in the same way as that of cosmetic cases – the dentist or periodontist will remove part of the gum line to create more space.

Crown Lengthening Procedure Steps

The crown lengthening procedure is typically completed in about an hour, depending on the technique required. The dentist will select the most appropriate technique based on the condition of the patient’s mouth, as well as the following considerations:

  • Proximity of root
  • Presence of bone loss
  • Aesthetic considerations
  • Length of root compared to the crown
  • Need for a filling or cap
  • Position of affected tooth or teeth


In order for the procedure to have the greatest chance of success, it’s important that the patient has healthy gums and good overall health. They should brush their teeth regularly, floss at least once per day, use mouthwash, and visit the dentist annually for a comprehensive evaluation and cleaning.

The dentist or periodontist will perform an analysis prior to surgery to assess the condition of the gum line, teeth, and surrounding structures. It is also possible for the patient to receive a  temporary crown in order to protect the tooth until the permanent crown can be placed about a month following the procedure.


The patient will receive local anesthetic, meaning that the medicine will be injected into the affected area for numbing. Thus, during the procedure, patients feel no pain. Depending on the cause, the dentist or periodontist will:

  • Remove parts of the gum tissue to promote symmetry
  • Create a “flap” of gum tissue to briefly lift and treat decay or damaged tooth underneath
  • Move a tooth to its desired position

When the process is complete, stitches will be placed, as well as gauze or a bandage if necessary.


Most patients do not require extensive post-operative care. The most common symptoms are minor pain, swelling, and bleeding during the first couple of days. Ibuprofen, acetaminophen, ice packs, and bandages will treat the symptoms. 

Patients may return to work as well as begin to consume soft foods the day following the procedure. However, strenuous activity should be avoided for two days.

Full gum tissue recovery will take about one to two weeks, at which time the stitches will be removed. After four to six weeks, the patient’s teeth and gums will be inspected and cleared for permanent restoration, depending on the cause.

Contact the Eureka, MO Crown Lengthening Experts

If you believe you are in need of crown lengthening, do not hesitate to schedule an appointment with Dr. Wehrmeister or Dr. G’Sell. Both dentists are experts in their field, and are dedicated to ensuring you leave the office with a smile. Their primary goal is to address all of your concerns by performing the necessary practices and procedures.

At Eureka Dental Group, our dentists and periodontists in Eureka, MO, provide the highest quality dental services for every member of the family. We can assure you that you will remain comfortable and relaxed during your visit. If you are experiencing issues with your gum line, we will work to restore your confidence and ease your pain. Contact us today to get started on the journey to relief!