Do I Need Crown Lengthening?
Crown lengthening is a periodontal procedure that adjusts the gum line to reveal more of a tooth’s structure. It can serve both restorative and cosmetic purposes, but not everyone is a good candidate. Whether it’s medically necessary or an aesthetic choice depends on the condition of your teeth, gums, and supporting structures.
When Crown Lengthening Is Recommended
Dentists typically suggest crown lengthening in a few key situations. The most common is when there isn’t enough visible tooth structure above the gumline to properly place a restoration, such as a crown or bridge. If a tooth has broken close to the gum or has decay extending beneath it, exposing more surface is essential for stability and function.
Another scenario is a “gummy” smile, where excessive gum tissue hides a significant portion of the teeth. In these cases, the procedure can reshape the gums for a more proportionate appearance. While cosmetic motivation alone doesn’t make someone a candidate, healthy teeth and gums in combination with aesthetic concerns can make crown lengthening a viable option.
It’s also used when gum tissue covers too much of the tooth due to irregular eruption patterns or certain medical conditions. In all of these situations, the goal is the same: create an appropriate balance between tooth, gum, and bone for either restorative work or improved aesthetics.
Who Qualifies as a Candidate?
Being a good candidate depends on more than just the presence of excess gum tissue. Healthy gums and adequate bone support are essential for successful healing. Active gum disease must be treated before crown lengthening is considered. Similarly, if significant bone loss has already occurred due to periodontal disease, the treatment plan may need to be modified or replaced with an alternative.
Candidates should also have realistic expectations about what the procedure can achieve. Crown lengthening will not lengthen or strengthen the tooth’s root; it only changes the visible crown portion. In cosmetic cases, the improvement is primarily about proportion and balance, not altering the natural shape of the teeth.
Medical history is another consideration. People with certain systemic conditions, like uncontrolled diabetes or blood-clotting disorders, may need medical clearance before undergoing periodontal surgery.
The Evaluation Process
Determining candidacy begins with a full dental examination, including X-rays to assess the tooth’s position relative to the surrounding bone. The dentist or periodontist will evaluate the amount of gum tissue to be removed and, if necessary, how much bone must be reshaped. They’ll also consider how the change will affect your bite and the overall health of neighboring teeth.
If crown lengthening is being done to prepare for a restoration, the restorative dentist and the periodontist will coordinate to ensure the new crown, bridge, or filling will have the proper fit and stability.
For the right candidate, crown lengthening can make essential restorative work possible or provide a more balanced smile. The decision ultimately comes down to the condition of your teeth and gums, the goals of treatment, and the recommendation of your dental care team. By addressing both function and aesthetics, the procedure can play a key role in long-term oral health.