When a tooth breaks or has large amounts of decay, it may need to be restored with a filling or a crown. In some instances, there may not be enough of the tooth exposed above the gum line to restore it. Crown lengthening is a surgical procedure performed to remove gum tissue or bone. The procedure exposes more of the tooth and allows for the restoration of the tooth.
To prepare for the procedure, x-rays will be taken. Although it will be removed during the procedure, a temporary crown may be made to cover the broken tooth. Because it is considered a specialized procedure, usually a general dentist will refer a patient to a periodontist who will perform a crown lengthening.
A crown lengthening procedure is done under local anesthesia to numb the mouth. An incision is made in the gum to pull back the gum tissue and allow the dentist to see the nerve and bone. Tissue is removed and possibility bone. Once it has been determined by the dentist enough of the tooth is exposed for restoration the area is flushed with sterile saline and the incision is stitched. Some dentists will cover the tooth with a protective dressing.
The amount of time it takes to perform a crown lengthening varies. Surrounding teeth may need to have tissue removed. Removing bone, along with gum tissue generally makes the procedure take more time. After the numbing medication wears off, the tooth and gum may be uncomfortable, so pain medication will likely be prescribed. A mouth rinse may also be recommended to promote healing. In some instances, antibiotics may be prescribed to prevent an infection.
Although a crown lengthening is considered safe, there are some risks and complications which can occur. Excessive bleeding at the incision site can occur. Some people may have sensitivity to hot or cold foods and drinks. Because some bone may be removed, it’s possible the tooth can become loose.
Another possible complication is an infection. Signs of a serious infection include, fever, excess swelling in the mouth, extreme pain and discharge from the incision site. If these symptoms occur, evaluation by your dentist is needed as soon as possible.
Usually a follow-up appointment will be needed to check the healing process and take out stitches. A permanent crown or filling may not be done until a few months after the surgery. This gives the gum time to heal properly.