Crown Lengthening & Gummy Smile

Crown Lengthening and Gummy Smile Treatment

Crown lengthening may be used to expose additional tooth structure for restorative treatment or to change the relationship between teeth and gums in selected aesthetic cases. A gummy smile can have several possible causes, so appropriate treatment begins with an individual assessment.

Functional Crown Lengthening

Functional crown lengthening may be considered when additional tooth structure is needed for:

  • a crown

  • a filling

  • management of decay below the gumline

  • management of a fracture

  • improving access for restorative treatment

The tooth must first be assessed as restorable. If it cannot be predictably restored, other options are discussed instead.

Aesthetic Crown Lengthening

Some patients wish to change uneven gum margins or reduce excessive gum display when they smile. Whether treatment is suitable depends on the underlying cause, the proportions of the teeth and the position of the gum and bone. A specific cosmetic result cannot be promised, and the realistic expectation for the individual case is discussed during planning.

Causes of Excessive Gum Display

Excessive gum display may relate to one or more of the following:

  • gum position

  • tooth shape or eruption

  • lip movement

  • jaw relationships

  • tooth position

  • a combination of factors

Not every gummy-smile concern is appropriately treated with gum surgery. Identifying the reason for the gum display comes first.

Coordinated Treatment Planning

Functional crown lengthening should be coordinated with the dentist providing the filling, crown or other restoration so that the sequence and timing suit the restorative plan. A typical decision sequence is:

  • the restorative dentist determines whether the tooth is restorable

  • root-canal assessment may be required

  • periodontal or crown-lengthening treatment is then planned where appropriate

  • extraction may be considered if the tooth cannot be predictably restored

Assessment

An assessment may include:

  • gum levels

  • tooth proportions

  • bone position

  • smile line

  • restorative needs

  • tooth prognosis

  • bite

  • imaging when appropriate

  • patient goals

What Patients May Expect

Treatment planning includes discussion of the proposed procedure, reasonable alternatives, expected healing, limitations and possible risks. The treatment itself, the healing time and the timing of the final restorative work all depend on the tooth, the procedure performed and the wider restorative plan. Individual instructions are provided before and after treatment.

About the Dentist

Dr. Maziar Shahzad Dowlatshahi is a general dentist in Ontario whose practice is focused on periodontal, implant, gum-surgery, oral-surgery and related surgical dental treatment.

Frequently Asked Questions

Is crown lengthening always cosmetic?

No. It is often performed to make additional tooth structure accessible for a crown, filling or other restorative treatment.

Can crown lengthening save every damaged tooth?

No. The tooth must be assessed for restorability, periodontal support, root condition and overall prognosis.

Does every gummy smile require gum surgery?

No. Excessive gum display can have several causes, and treatment depends on the underlying reason.

When can a crown be placed after crown lengthening?

Timing depends on the procedure, healing and restorative plan. The treating dentists will coordinate the sequence.

Related Services

Request a Crown-Lengthening Assessment

Book an appointment to discuss restorative crown lengthening, uneven gum margins or excessive gum display.