Reviewed by Dr. Nicole M. Berger, DDS — South Florida Smile Spa, Pompano Beach, FL
Crown lengthening in Pompano Beach at South Florida Smile Spa is a small gum surgery with two very different jobs. For a tooth that has broken or decayed below the gumline, it exposes enough sound tooth for a crown to grip, so the tooth can be saved instead of pulled. For a gummy smile, where the teeth look short because gum covers too much of them, it reshapes the gumline so the teeth show at their true length. The surgery is the same in principle; the planning is not. This page explains both uses, how our periodontist performs it, what recovery is like, and how it fits with the crown or veneers that usually follow.
Quick answer
Crown lengthening is a minor surgical procedure that removes a small amount of gum, and sometimes bone, from around a tooth to expose more of it. Functionally, it is done when decay, a fracture or an old crown margin sits below the gumline, so Dr. Berger has solid tooth to build a new crown on and the gum can stay healthy around it. Cosmetically, it corrects a gummy smile by moving the gumline up on teeth that look short, usually the upper front six to ten, before veneers or on its own. Our periodontist at South Florida Smile Spa in Pompano Beach performs it under local anesthetic in about an hour; the gum heals in one to two weeks and settles fully in six to twelve weeks, when the final crown or veneers are made.
Two Reasons
When crown lengthening is the answer
- A tooth broken at or below the gum. A crown needs about two millimeters of sound tooth above the bone to hold onto, and the gum needs its own two to three millimeters of attachment above that. If the break is deeper, lengthening moves the gum and bone down to create that room. The alternative is extraction.
- Decay under an old crown or filling that has crept below the gumline, where it cannot be cleaned out or sealed without the gum growing over the margin and staying inflamed.
- A crown that never sits right. Chronic redness, bleeding or a “purple” gum around an existing crown often means the margin was placed into the attachment zone; lengthening fixes the cause.
- A gummy smile. When more than three or four millimeters of gum show above the upper teeth, or the teeth look square and short, the teeth are usually normal length and simply covered. Lengthening uncovers them.
- Before veneers. Veneers on short teeth look wrong; lengthening first lets Dr. Berger design properly proportioned veneers.
The American Dental Association’s page on crowns explains what a crown does and why the tooth under it has to be sound.
Functional vs. cosmetic crown lengthening
| Functional (to save a tooth) | Cosmetic (gummy smile) | |
|---|---|---|
| Goal | Expose 3 to 4 mm of sound tooth so a crown can be made and the gum stays healthy | Move the gumline so the teeth show at their natural length and the gumline is even |
| Teeth involved | Usually one tooth, sometimes the neighbors for a smooth gum contour | Typically the upper six to ten front teeth |
| Bone removed? | Almost always a small amount, to re-establish the space the gum attaches to | Depends on where the bone sits; the exam and X-rays decide, and a gum-only procedure is sometimes enough |
| Planning | Dr. Berger marks how much tooth the crown needs; a temporary crown is often placed first | A digital smile design and a wax-up set the new gumline before surgery; a surgical guide is made from it |
| What follows | Final crown made 6 to 8 weeks after surgery, when the gum has settled | Nothing, or veneers 8 to 12 weeks later once the gumline is stable |
| Insurance | Usually covered in part as periodontal surgery | Usually not covered |
The Procedure
What happens during crown lengthening
- Planning. For a broken tooth, Dr. Berger confirms the tooth is worth saving, treats any root canal need, and marks the margin the crown will need. For a gummy smile, a smile design shows you the proposed gumline before anything is done.
- Anesthesia. Local anesthetic; nitrous oxide or IV sedation is available and often chosen for a full cosmetic case across many teeth.
- Gum. Our periodontist removes a precise strip of gum, following the guide, and lifts the remaining gum back a few millimeters to see the bone edge.
- Bone. Where needed, a thin layer of bone is reshaped so that the distance from bone to the new gumline matches the natural 2 to 3 mm the gum needs to attach. Skipping this step is why gums grow back over some lengthening procedures.
- Closing. The gum is positioned at its new level and secured with fine sutures. About 45 to 60 minutes for one tooth, up to two hours for a full cosmetic case. A temporary crown or bonding may be placed the same day.
Recovery and timing of the final restoration
Expect mild soreness and some swelling for two or three days, managed with over-the-counter pain relievers, and a few days of soft food. Stitches dissolve or come out at one to two weeks, when normal brushing resumes with a soft brush. The gum looks healed at two weeks, but it keeps settling for much longer, and that settling is the reason the final crown or veneers are not made right away. For a single back tooth the margin is stable enough at six to eight weeks. For front teeth, where a millimeter of gum movement is visible, Dr. Berger waits eight to twelve weeks, and sometimes longer, so that the restoration is made to the gumline you will actually have. A temporary crown or temporary bonding covers the tooth meanwhile. Sensitivity to cold on the newly exposed root is common for a few weeks and settles; it is covered once the crown is on.
Gummy smile: is crown lengthening the right fix?
A gummy smile has several possible causes, and lengthening only treats one of them. If the teeth are normal length but covered by gum that never fully receded after eruption, which is the commonest cause in people under forty, lengthening is exactly right and the results are permanent. If the upper lip lifts unusually high when you smile, the teeth may be perfectly proportioned and the fix is a small amount of Botox in the lip-elevator muscles or, occasionally, a lip-repositioning procedure. If the whole upper jaw is long, which shows as a gummy smile even at rest, orthodontics or jaw surgery is the honest answer and lengthening alone will disappoint. Dr. Berger measures tooth length, lip movement and gum display at the consultation and tells you which you have, and whether lengthening, Botox, veneers or a combination will give the result you are picturing. Our smile makeover page describes how these are combined.
Alternatives for a broken tooth
Orthodontic extrusion, where a bracket and a light elastic pull the broken root upward over a few weeks until enough tooth is above the gum, avoids bone removal and is sometimes preferred on front teeth, though it takes longer and the root is then shorter. A crown with a deep margin and no lengthening is occasionally attempted, but the gum around it stays inflamed and the crown tends to fail. And extraction with an implant is the right call when the remaining root is too short, cracked down its length, or would need so much lengthening that the tooth would look unnatural and the neighbors would lose support. Dr. Berger lays the options side by side, with the X-ray, before anything is scheduled. Our dental crowns page covers the restoration that follows.
Cost and insurance
Functional crown lengthening on a single tooth is usually covered in part by dental insurance as periodontal surgery, typically at 50 to 80 percent after the deductible, when the X-ray shows the break or decay below the gum; the crown is billed and covered separately. Cosmetic lengthening for a gummy smile is priced per tooth or per arch and is not covered, though it is often bundled into a smile makeover plan with veneers. Our team verifies your benefits and gives you the figures for the surgery and the restoration together, so you see the whole cost of saving the tooth or reshaping the smile before you decide.
Care in Pompano Beach
Why patients choose South Florida Smile Spa for crown lengthening
- Surgeon and restoring dentist in one office. Our periodontist performs the lengthening to the margin Dr. Berger has planned, and she makes the crown or veneers that follow, so the two halves of the treatment match.
- Smile design first. For a gummy smile you see the proposed gumline before surgery, and the periodontist works to a guide made from it.
- The right diagnosis. Covered teeth, a high lip or a long jaw are different problems; you are told which you have and what will actually fix it.
- Patience with the gumline. Final restorations are made once the gum has settled, not on a schedule, so the margin stays where it was designed.
- Whole-cost quote. Surgery and restoration priced together, with insurance verified, before you commit.
Patients come to us for crown lengthening from Pompano Beach, Lighthouse Point, Deerfield Beach, Fort Lauderdale and Coconut Creek, both to save a broken tooth and to correct a gummy smile.
A tooth broken at the gum, or a smile that shows too much gum
Book a consultation. Dr. Berger will tell you whether crown lengthening saves the tooth or fixes the smile, what the alternatives are, and what the whole plan costs.
South Florida Smile Spa · Dr. Nicole M. Berger, DDS · 572 E McNab Rd, Suite 102, Pompano Beach, FL 33060 · (954) 785-1100
Frequently Asked Questions
Is crown lengthening painful?
Not during the procedure, which is done under local anesthetic with sedation available. Afterward, expect mild soreness and some swelling for two or three days, managed with over-the-counter pain relievers. A single tooth is usually easier than patients expect; a full cosmetic case across several teeth is sorer for a few days longer.
How long does crown lengthening take to heal?
The gum looks healed in about two weeks, when the stitches are out. It keeps settling for six to twelve weeks, which is why the final crown or veneers wait until then. A temporary covers the tooth in the meantime.
Will my teeth look longer?
Yes, by the amount of gum removed, which is the point in a cosmetic case and is designed in advance. For a single back tooth it is rarely noticeable. For a front tooth treated on its own, the neighbors are sometimes adjusted slightly so the gumline stays even, and the crown is designed to the new length so the tooth does not look out of place.
Can the gum grow back after crown lengthening?
A little rebound is normal in the first weeks, which is why restorations wait. Significant regrowth happens when gum is trimmed without reshaping the bone beneath it, because the gum re-establishes its natural 2 to 3 mm attachment above the bone. Properly done, with the bone level adjusted where needed, the result is permanent.
Can crown lengthening be done with a laser?
A laser can trim gum precisely with little bleeding, and for a gummy smile where only gum needs to be removed it works well. Where bone has to be reshaped, which is most functional cases and many cosmetic ones, conventional surgery is needed to reach it. Our periodontist chooses from the X-rays and the exam.
Who performs crown lengthening at South Florida Smile Spa?
Our periodontist, who comes to the office to perform periodontal and surgical procedures. Dr. Berger plans the restoration or the smile design the surgery serves, provides sedation if wanted, and makes the crown or veneers afterward, so the surgery and the restoration are planned together.
Is crown lengthening better than extracting the tooth?
Usually, when the root is long and sound. Keeping your own tooth preserves the bone and avoids an implant. When the root is short, cracked, or would need so much bone removed that the tooth and its neighbors would be weakened, extraction and an implant is the better long-term choice. Dr. Berger shows you the X-ray and explains which applies.
Does insurance cover crown lengthening?
For a broken or decayed tooth, usually in part, as periodontal surgery, when the X-ray documents the need; the crown itself is covered separately. For a gummy smile it is cosmetic and not covered. We verify your benefits and quote the surgery and the restoration together.
Do you see patients from outside Pompano Beach?
Yes. Patients come for crown lengthening and cosmetic gum reshaping from Lighthouse Point, Deerfield Beach, Fort Lauderdale, Coconut Creek and across Broward County. The office is at 572 E McNab Rd, Suite 102, Pompano Beach. Call (954) 785-1100 or request an appointment.