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gummy smile

What is Crown Lengthening?

Crown Lengthening

Crown lengthening is generally performed to improve the health of the gum tissue or to prepare the mouth for restorative or cosmetic procedures.  In addition, crown lengthening procedures can also be used to correct a “gummy” smile, where teeth are covered with excess gum tissue.  Crown lengthening exposes more of the natural tooth by reshaping or recontouring bone and gum tissue.  This treatment can be performed on a single tooth, many teeth, or the entire gum line, exposing an aesthetically pleasing smile.

Reasons for crown lengthening

Crown lengthening is a versatile and common procedure that has many effective uses and benefits.  The vast majority of patients who have undergone this type of surgery are highly delighted with the results.

Here are some of the most common reasons for crown lengthening:

  • Restoration of damaged teeth – Periodontal disease can cause severe damage to the teeth, as can trauma and decay.  Where teeth have been broken beneath the gum line, crown lengthening can be used to prepare the area for a new restoration to correct the damaged teeth.
  • Cosmetic uses – Extra gum tissue can make teeth look unnaturally short and can also increase susceptibility to periodontal infections.  Removing excess gum tissue can restore a balanced, healthy look and improve the aesthetic appearance of the smile.
  • Dental crowns – Crown lengthening provides more space between the supporting jawbone and dental crown.  This prevents the new crown from damaging gum tissues and bone once it is in place.

What does crown lengthening involve?

Your dentist will make a series of small incisions around the soft tissue in order to separate the gums away from the teeth.  Even if only one tooth requires the re-contour, neighboring teeth are usually treated to provide a more even reshaping.  Separating the gums provides your dentist with access to the roots of the teeth and the underlying bone.

In some cases, the removal of a small amount of tissue will provide enough tooth exposure to place a crown.  In other cases, your dentist will also need to remove a small amount of bone from around the teeth.  The bone is usually removed using a combination of special hand instruments, and rotary instruments.  The rotary instruments roughly resemble the drill that is used in cavity treatment.

The teeth will look noticeably longer immediately after surgery because the gums will have been repositioned. The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned.

Your dentist may secure the surgical site using an intraoral (periodontal) bandage which serves to prevent infection.  Prescriptions may be provided for pain medication, and a chlorhexidine (antimicrobial) mouth rinse will be given to help reduce any bacteria attempting to recolonize.  The surgical site will be completely healed in approximately two to three months.

Gingival (Gum) Excess

Gingival (Gum) Excess

Healthy gums are an important part of a person’s general oral hygiene and appearance.  Sometimes in certain people the gums can grow and build up over the front surface of a tooth. This can often occur when patients have braces on their teeth. This formation of extra gum can change the balance between the length of the teeth and the height of the gum line, leading in some cases to a person having an uneven smile.

Before and After Ginigvectomy by Dr. Todd Britten

Gingivectomy is best described as the surgical removal of excess gum tissue.

Your orthodontist or family dentist may recommend gingivectomy for several reasons:

  • Prevent teeth from shifting after orthodontic appliances have been removed.  Excess tissue can cause the teeth to separate even though braces have brought the teeth together. 
  • There are gaps or pockets that have formed between your teeth and your gums. These pockets will trap food particles, harbour colonies of bacteria, and make it difficult for you to clean. If the pockets only involve soft tissues then these gaps may be removed by simply trimming the gums through gingivectomy.
  • There is too much gum tissue for your teeth. Aside from cosmetic reasons, too much gum tissue for your teeth will make it hard for you to keep your mouth clean. In severe situations, this condition can interfere with the way you eat and the way you talk.

Gummy Smile? No Problem!

Q:  I have big gums and short teeth, so when I smile you can almost only see my gums. I don’t smile very often anymore because I am so self conscious of my gums. Is there a way to improve my smile?

A: Yes, there may be a way to enhance your smile. It’s a good idea to discuss your options with a periodontist first. He or she can explain the best way to create the smile you want, as well as answer any questions that you may have. For example, one procedure that can remove excess gum tissue is called crown lengthening. After the excess gum tissue is removed, the gum line is then reshaped in order to create the right proportion between gum tissue and tooth surface. Your general dentist and periodontist may also work together to coordinate additional treatments such as veneers or crowns. However, your periodontist and general dentist will recommend the best procedure to improve your smile.

–Perio.org

Getting a beautiful smile with cosmetic crown lengthening

Unhappy with the appearance of a “gummy” smile? You may be a good candidate for a procedure called cosmetic crown lengthening.

This periodontal procedure is designed to expose more tooth structure prior to restorative and cosmetic dentistry and/or to improve the esthetics of your gum line. A frequently asked question is whether we can change the esthetics of a gummy smile because the teeth appear somewhat short. Your teeth can actually be of proper length and just covered with excessive gum tissue. In such circumstances, a crown lengthening procedure will correct this by exposing the shape of your natural teeth.

Crown lengthening can also be done to single teeth to “even out” your gum line and create a more symmetrical smile.

If your teeth are decayed, fractured at or below the gum line or have insufficient tooth structure for new crown retention, a “Clinical crown lengthening” procedure may be recommended by Dr. Britten to enable your general dentist to perform a restorative and/or cosmetic dental procedure.

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