Crown lengthening pain, healing, and risks

A crown lengthening procedure is a minor surgical procedure that removes and reshapes gum tissue, and possibly small amounts of underlying bone, to allow a larger portion of the surface of a person’s tooth or teeth to be visible. Some crown lengthening procedures are performed for medical reasons, to expose a larger area of healthy tooth and facilitate the secure and comfortable placement of a crown or other restoration. Some crown lengthening procedures are performed for aesthetic reasons, if a person’s smile shows more gum tissue than they would like, which can make the teeth appear shorter than they are. Regardless of the reasons for a crown lengthening procedure, it is helpful to understand the treatment process, including healing, and to be aware of any potential risks.

In a crown lengthening procedure, a periodontist or other dental surgeon will remove and resculpt gum tissue, and sometimes small amounts of bone, to expose a larger portion of the tooth’s surface. The procedure is very common and usually takes no more than an hour to complete. Before the surgical procedure begins, you will review your medical history with your periodontist and they will review your dental x-rays. You may be asked to provide a list of any medications you take, so that the periodontist can determine if these may cause any complications; in some cases, people are asked to discontinue certain medications before the procedure can be safely completed. The procedure itself is an outpatient procedure, so you will be able to leave the periodontist’s office shortly after the procedure is completed. The duration of the procedure itself will vary depending on the number of teeth that are being treated, the extent of tissue and bone that may need to be removed, and the possible presence of any existing crowns.

Most patients receive local anesthesia, though some may also undergo sedation. During the procedure, the periodontist makes small incisions in the gums and pulls them back from the teeth, revealing the underlying bone and the roots of the teeth. The doctor will then cleanse the area with saline, sculpt the gum tissue as needed, and suture the gums back into place. Sometimes, a small amount of bone will also be removed or reshaped. Once the numbness from local anesthesia subsides, you will feel some pain. You may receive a prescription for pain relievers and an oral rinse that will aid in healing.

The risk for infection in a crown lengthening procedure is minimal and should be considered comparable to any other minor surgical procedure. Be sure to carefully adhere to postoperative guidelines and contact your dentist if questions or concerns arise while you are recovering. While recovering, there may be some bleeding at the surgical site, and you may find that your teeth are sensitive to extreme temperatures. These symptoms usually resolve soon after the procedure. The treated tooth may appear longer than adjacent teeth, and, if the periodontist removed any bone, the treated tooth may feel somewhat loose. Again, this should resolve relatively quickly.

While it takes about three months for the gum tissue to completely heal, you will be able to resume regular habits sooner. It is recommended that you avoid strenuous activity immediately following the procedure, as heavy exertion may cause excessive bleeding; however, you should be able to return to normal activity within two or three days. Your periodontist or surgeon will provide specific guidelines for your recovery, but there are some general rules that will help the healing process go smoothly.

You may receive a prescription for painkillers, but most patients find relief from taking over-the-counter pain medications, like acetaminophen or ibuprofen, at regular intervals. You also may receive a prescription for antibiotics; be sure to complete the entire course of antibiotics to protect against infection. An ice pack applied to the outside of the face shortly after the procedure can help reduce swelling, and you may prefer to use moist heat on the face starting a few days after the surgical procedure. For the first 24 hours, refrain from eating hot foods, and don’t rinse out your mouth, as excessive heat or vigorous rinsing can prolong post-surgical bleeding. If bleeding continues for longer than you like, you may want to apply slight pressure to the surgical area with a moistened tea bag or damp gauze for about 20 to 30 minutes. Your doctor will pack the surgical site with dressing following the procedure, and they may ask you to return to their office periodically so that they can replace this dressing while the sutures are still in place, for up to two weeks. Then, they will remove the sutures. While the sutures are in place, be careful while brushing your teeth, focusing only on the biting surfaces near the surgical site. It is fine to floss and brush the rest of your mouth as you normally would. You should also try to chew on the teeth that are farthest away from those that have been treated.

If your doctor provided you with a stent or denture as part of your recovery, leave it in place for 24 hours. If the site bleeds excessively, rinse with salt water or chlorhexidine, and do not remove the stent or denture for at least 24 hours. After 24 hours, you may remove it as you wish. Avoiding the surgical area while eating, maintain a diet of soft foods, and don’t eat anything spicy, acidic, or highly seasoned. Be sure to drink plenty of non-alcoholic fluids, and avoid alcohol until after you’ve had your follow-up appointment. You should also avoid smoking for at least 7 to 10 days, if not longer. Don’t poke or prod the area with your finger or tongue, and avoid using straws, as suction may dislodge sutures. Additionally, pulling on the lip to examine the surgical site may damage the site and should be avoided. Crown lengthening is a common procedure, and, when performed by a qualified periodontist, oral surgeon, or other dental professional, the procedure can be expected to go smoothly and can help improve the health of your teeth and the beauty of your smile.

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