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Crown lengthening is a periodontal procedure used to correct a “gummy” smile— a condition where teeth appear too short or too small. This condition can result from several causes. Periodontal disease can cause the gums to overlap tooth enamel and make them look shorter than they are. Teeth that have been filled with primitive amalgam fillings, or capped with outdated gold crowns, can often decay to the point that they lose a great deal of their enamel and dentin. When the amalgam or gold cap eventually falls out, the tooth appears to withdraw into the gum line. Teeth that are damaged in an accident can even break off at the gum line itself, making it appear that the person has lost them altogether.
 
 
Dentists in past years would have extracted the majority of these teeth. This is not the case today. More recent advances in the science of restorative dentistry have made it possible to both save these teeth from a functional perspective, and also to restore them aesthetically.
Crown lengthening can be done with traditional surgical instruments, or it can be performed using the PerioLase® MVP-7, which is the laser also used to perform LANAP. The choice of surgical methods will depend on a number of factors ranging from the patient’s medical history, the presence of disease in the gums, and whether or not the tooth itself has decayed or been broken. The dentist will make this determination, take x-rays of the mouth, and then perform the surgery.
Regardless of the method ultimately chosen to perform the actual surgery, the procedure itself is basically the same. Local anesthetic is usually applied to the gums to prevent discomfort. The dentist then makes the necessary incisions and pulls back the gums until a suitable amount of tooth surface is exposed. The dentist then reshapes the excess gum and bone tissue to look proportional and healthy in relationship with the person’s smile. Once the gums have been readjusted in this fashion, they are fixed in place with a couple of stitches and given a prescribed time to heal by the dentist.
After the post-operative healing is complete, the patient returns for a follow up dentist. The stitches are removed, and a cosmetic dental crown is then placed over the tooth. This porcelain crown will provide a chewing surface equivalent to that of natural teeth, and it will prevent further tooth decay from occurring underneath its surface. It also helps prevent a “gummy” smile from reforming because it provides the gum line with a uniform, solid surface that prevents gums from drooping or growing unnaturally long.
The many benefits of crown lengthening are causing an increasing number of cosmetic dentists to recommend it as a precursor to other restorative and cosmetic dental procedures. For one thing, it can prove very effective in helping to treat certain stages of gum disease. It can also help save many teeth that would otherwise continue to decay and eventually require extraction, and it allows the patient to also eat a normal diet without fear of damaging their teeth. Cosmetically, it offers the patient the confidence of a natural smile they can share with the world without embarrassment or fear.
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