Crown Lengthening Waterloo
Crown lengthening is generally performed in order 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, to expose a pleasant, 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 also increase susceptibility to periodontal infections. Removing excess gum tissue can restore a balanced, healthy look and thus improve the aesthetic appearance of the smile.
- Dental crowns – Crown lengthening serves to provide 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?
Crown lengthening is normally performed under local anesthetic. The amount of time this procedure takes will largely depend in how many teeth are involved and whether a small amount of bone needs to be removed, in addition to the soft tissue. Any existing dental crowns will be removed prior to the procedure, and replaced immediately afterwards.
The 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 the 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, the 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.
When the dentist is satisfied the teeth have sufficient exposure, the wound will be cleaned with sterile water and the gum tissue will be sutured with small stitches. The teeth will look noticeably longer immediately after surgery because the gums have now been repositioned.
The dentist in Waterloo will 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 may be given to help reduce any bacteria attempting to re-colonize. The surgical site will be completely healed in approximately two to three months.
Crown Lengthening in Waterloo – Book Your Consultation
If your teeth look too short or you need treatment to support a dental crown, crown lengthening can help. At Trillium Dental Centre, we offer periodontics in Waterloo to improve gum health and enhance your smile. Call 519-746-4000 to schedule your visit.
If you have any questions about crown lengthening, please ask your dentist.
What to Expect During Crown Lengthening
Crown lengthening is a minor surgical procedure that exposes more of the tooth structure above the gum line. It's done either for a functional reason — when a tooth has broken at or below the gum line and needs more length for a crown or filling to anchor to — or for cosmetic reasons, to reduce a 'gummy' smile where gums cover too much of the visible teeth.
Treatment is performed under local anaesthetic. We elevate a small flap of gum tissue around the tooth, remove a precise amount of bone if needed (so the new gum margin sits at the right level), and reshape the gum tissue. The flap is repositioned and secured with a few sutures. The procedure usually takes 30 to 60 minutes per tooth or per cosmetic site.
Healing happens over several weeks. For functional cases (preparing for a restoration), we wait 4 to 6 weeks before taking impressions for the crown or completing the filling, so the gum line has stabilized at its new position. Cosmetic cases also benefit from a similar wait before any further work.
Who Is a Candidate for Crown Lengthening
Crown lengthening is indicated when:
- A tooth has broken at or below the gum line and needs more vertical clearance for a crown to grip
- Decay extends below the gum line, requiring exposure for clean restoration
- A 'gummy smile' makes teeth look short — sometimes from incomplete eruption rather than abnormal growth
- Asymmetric gum levels affect the cosmetic appearance of an otherwise straight smile
- An existing restoration has a poorly fitting margin that's causing recurring gum inflammation
Patients with active periodontal disease need the disease stabilized before crown lengthening — surgery on inflamed tissue heals less predictably. Smoking significantly affects healing in this procedure; we discuss cessation options. Some bite issues or tooth root anatomy can make crown lengthening unsuitable for a given tooth — we'll tell you if that's the case at the consultation.
Healing and Aftercare
Most patients return to office work the next day. Expect mild to moderate swelling around the treated area for two to four days; cold compress on the cheek (15 minutes on, 15 off) during the first 24 hours helps. Some bruising along the gum line is common and fades within a week.
Pain is usually well controlled with over-the-counter medication; prescription pain medication is sometimes provided for the first day or two. Soft diet for the first few days, avoiding the treated side. The sutures are usually self-dissolving — they fall away on their own within 7 to 10 days.
Brushing the treated area gently with a soft brush is safe after the first 24 hours; we may prescribe an antimicrobial mouth rinse for the first two weeks. We see you back at one week to check the site, again at four to six weeks before proceeding with any restorative work, and at three to six months to assess final tissue position.
Cost and Insurance Coverage
Crown lengthening fees depend on whether it's a single tooth or multiple teeth, and whether bone reshaping is involved (more time and complexity than gum-only adjustment). We follow the current Ontario Dental Association (ODA) Suggested Fee Guide and provide a written estimate at the consultation.
Functional crown lengthening (preparing for a restoration) is generally covered under basic or major services on extended dental insurance — coverage levels vary by plan. Cosmetic crown lengthening for a "gummy smile" is sometimes considered cosmetic and excluded from coverage; we submit predetermination so you know in advance. The federal Canadian Dental Care Plan (CDCP) covers some related services for eligible patients.
Crown Lengthening — Frequently Asked Questions
Will the tooth look longer?
Yes — that's the point. For functional cases, the increased exposure lets the crown anchor securely. For cosmetic cases, the new gum line evens out the smile so the visible teeth look proportional. We can show you mock-ups before treatment so you know what to expect.
Will I have a visible gap above the gum?
No. The procedure repositions the gum and bone together so the gum line just sits at a new level. There's no visible gap or step at the gum line once healing is complete.
How long does the new gum level last?
Once fully healed (3-6 months), the new gum position is generally stable long-term, similar to your other teeth. Gum levels can shift over years with aging, but not in a way that undoes the procedure.
Can crown lengthening be done on any tooth?
Most teeth, yes, but the answer depends on root anatomy and the ratio of crown to root after the procedure. A tooth that would have too little root remaining in bone after lengthening isn't a good candidate — we'd discuss alternatives like extraction and replacement with an implant.
Will my crown last as long as a crown without lengthening?
Yes. A crown placed on a properly lengthened tooth has the same long-term outlook as a crown placed on any other healthy tooth. The lengthening creates the conditions for a well-fitting, well-margined crown — which is what determines longevity.