Crown Lengthening in Grand Junction

Two different problems, one procedure

Crown lengthening reshapes gum — and usually a small amount of bone — to expose more of the tooth. People arrive needing it for one of two entirely unrelated reasons.

Functional: there isn't enough tooth to work with

A tooth broken at or below the gumline, or a deep cavity, leaves your dentist nothing to grip. A crown cemented onto too little structure comes off, repeatedly. Crown lengthening exposes sound tooth so the restoration has something to hold.

It also protects something called biologic width — the narrow zone of tissue between the bone and the edge of a restoration. Crowd a restoration into that space and the gum stays chronically inflamed, bleeds, and eventually recedes. This is a surprisingly common cause of a crown that "never felt right" and a gum that never settled.

Esthetic: too much gum shows when you smile

A gummy smile is usually teeth that are the right size hidden under gum that sits too low, not teeth that are too short. Reshaping the gumline reveals the tooth that's already there and evens out a line that sits higher on one side than the other.

What actually happens

1. Planning. For esthetic cases, where the new gumline should sit is decided with you before anything is done — with your dentist involved if a restoration is coming.
2. The procedure. Under local anaesthetic, gum tissue is reshaped and a small amount of bone is usually recontoured. Bone is the part people don't expect, and it's the part that makes the result stable — trimming gum alone tends to grow back.
3. Healing. Soft tissue settles over roughly two weeks. Where a crown is going on, most cases wait longer before the final restoration so the gumline has stopped moving — rushing this is how you get a crown margin that shows a year later.

Recovery

• Mild soreness for a few days; over-the-counter medication is usually enough.
• Soft foods for the first several days, and avoid the surgical area when brushing until cleared.
• Most people return to work the next day.
• Some sensitivity at the newly exposed tooth surface is normal and settles.

When it isn't the right answer

If exposing enough tooth would compromise the bone support of the neighbouring teeth, or leave the root looking obviously long, crown lengthening is the wrong tool. Orthodontic extrusion — moving the tooth up rather than cutting the gum down — is sometimes better, and occasionally the honest answer is that the tooth should be replaced rather than restored. You'll be told that, if it's true.