Patient Guide for Clinical Crown Lengthening

Q: Why do I need this surgery? Can't you just place the filling/crown?

This is the most important question we can answer. For any dental restoration—whether a filling or a crown—to be successful and long-lasting, it must be placed on a clean, dry, and healthy tooth foundation. When a cavity or fracture goes too deep below the gum line, it’s impossible to properly isolate and bond the restoration. This surgery is designed to precisely lower the gum and bone levels, exposing that necessary foundation. Attempting a restoration without this step would trap moisture and bacteria, leading to leakage, sensitivity, and the ultimate failure of the filling or crown.

Q: What is "biologic width" and why is it important?

“Biologic width” is the name for the natural seal of tissue your body needs around a tooth to stay healthy. If the edge of a restoration invades this space, your gums will be chronically inflamed, red, and will bleed forever. This surgery re-establishes a healthy biologic width, preventing this chronic inflammation and ensuring the long-term health of your gums around the new restoration.

Q: Are there any alternatives to this surgery?

Yes, and that’s an excellent question. Our philosophy is always to be as conservative as possible. Depending on the specific situation, alternatives can include: Rapid Orthodontic Extrusion: This is a non-surgical approach where we use a temporary brace to quickly pull the tooth further out of its socket over several weeks. This is done rapidly so that the surrounding gum and bone do not follow the tooth, effectively exposing more of the root surface. The tooth is then held in this new position to allow everything to stabilize. Deep Margin Elevation: Using advanced bonding techniques to build up the deep edge of the tooth with a filling material. We have recommended this surgical approach for your specific case because we believe it provides the most predictable and stable foundation to ensure the long-term success of your new restoration.

Q: What are the next steps after I heal?

The healing process for crown lengthening is crucial and takes time. Your gum tissues need to fully mature in their new position, which typically takes about 6 to 8 weeks. After this healing period, your tooth will be ready for the final, definitive restoration, whether that is a new resin filling or a permanent crown.

Surgical Care Instructions

Pain Management

It is normal for the surgical area to be sore for several days as the gums heal in their new position.

Standard Protocol: For the first 2-3 days, we recommend a scheduled regimen of 600mg of Ibuprofen AND 500mg of Tylenol (Acetaminophen) taken together every 6 hours. This proactive approach is highly effective at managing inflammation.
Important Disclaimer: Only take medications as specifically prescribed by our office, considering your unique health history.

Bleeding Control

Minor oozing of blood from the surgical site is normal for the first 24 hours.

Pressure: If you notice active bleeding, apply firm but gentle pressure to the area with a piece of moistened gauze for 30 minutes.
Avoid: Do not spit, use a straw, or smoke. Avoid vigorous rinsing, as this can disturb the healing site.

Swelling Management

Swelling and bruising are common and expected parts of the healing process.

Ice Packs (CRITICAL): For the first 24 hours ONLY, apply an ice pack to the outside of your face over the surgical area for 20 minutes on, then 10 minutes off.
Peak Swelling: Swelling will be at its worst on the third day after surgery, after which it will begin to gradually subside.

Oral Hygiene/Site Care

The healing of your gum tissues in their new, correct position is essential for the success of your future restoration.

DO NOT pull your lip or cheek back to look at the site. This can tear the delicate sutures.
The “White Patch” is Normal: It is completely normal for the surgical site to develop a soft, white layer. This is not an infection; it is a natural healing bandage your body creates.
Rinsing: Do not rinse for 24 hours. After that, you may begin gently rinsing with the prescribed medicated rinse or warm salt water after meals. Let the water fall out of your mouth; do not spit.
Brushing: You can and should brush all other teeth normally, but stay completely away from the surgical site until your sutures are removed and we instruct you otherwise.

Dietary Recommendations

Stick to a soft, non-chew diet for the first several days.
Do not chew on the side of your mouth where the surgery was performed.
Avoid hard, crunchy, or spicy foods that could irritate the surgical site.

Activity Restrictions

Avoid all strenuous physical activity, exercise, or heavy lifting for at least 3-5 days. Increased blood pressure can cause bleeding and pressure at the surgical site.