Crown lengthening has traditionally been done with a scalpel and stitches. Today, many patients can have it done with a laser instead. Laser dentistry procedures tend to cause less bleeding and swelling, and healing is often quicker than with traditional surgery.
The goal is the same either way: remove a small amount of excess gum tissue, and sometimes bone, so more of the tooth shows. That gives a dental crown enough healthy tooth to hold onto, or evens out a smile where the gums cover too much of the teeth.
When Is a Laser an Option for Crown Lengthening?
A laser is usually an option when only gum tissue needs to be removed. That covers many restorative cases and most gummy smile cases, where the bone sits at a healthy level and the gum has simply grown too far down the tooth.
When the bone around the tooth also has to be reshaped, the crown lengthening procedure is more involved. Some of that work can still be done with a laser, but some cases need a traditional surgical approach, and a periodontist may be recommended. X-rays and gum measurements tell us which group your tooth falls into, so you will know before treatment which technique is planned and why.
Types of Laser Crown Lengthening
The term laser crown lengthening can encompass several different applications, such as:
Cosmetic-based
People who get laser crown lengthening for cosmetic reasons typically do so to help their teeth look more normal in size. People who have a “gummy smile” have gums that overshadow the natural size of their teeth. Laser crown lengthening may increase one’s confidence and make them more likely to smile without being self-conscious.
Restoration-based
Sometimes a tooth is too short, worn or broken near the gum line to hold a crown securely. Removing a little gum tissue exposes more of the tooth, so the crown has enough surface to grip and the edge of the crown sits on healthy tooth.
Therapy-based
Overgrown gum tissue can form pockets that trap food and bacteria and are hard to keep clean. Trimming that excess soft tissue can make the area easier to brush and floss. If the pockets come from gum disease rather than extra tissue, the right treatment is different, usually a deep cleaning or laser gum disease treatment.
Not sure which of these applies to you? Dr. Tummala will look at the tooth, take X-rays and explain what she recommends before anything is scheduled.
Advantages of Laser Crown Lengthening
Compared with traditional crown lengthening surgery, a laser technique can offer several advantages:
- Less invasive. The laser removes soft tissue precisely, without a scalpel.
- Local anesthesia only. The area is numbed. General anesthesia is not needed.
- Often no stitches. The laser seals small blood vessels as it works, so bleeding is reduced and stitches are usually not needed for gum-only cases.
- Less swelling. Some swelling and tenderness is normal after any gum procedure, and it is typically milder after laser treatment.
- Lower infection risk. The laser helps reduce bacteria in the area it treats.
- Quicker healing. Less bleeding and swelling usually means a faster recovery.
What Happens During a Laser Crown Lengthening Procedure?
The dentist or hygienist will do a physical examination including dental x-rays to determine whether laser crown lengthening is a good option for the patient. Once that is determined, the next step may be making a separate appointment for the procedure.
The patient should expect to have their teeth cleaned before any work begins as this can help cut down on bacteria and decrease the risk of infection.
Anesthesia is normally localized, but there are other options for patients who require something stronger or suffer with dental anxiety. Once the area is numb, the laser crown lengthening procedure can begin. The laser uses a beam of light to help sculpt and cut into the gum tissue to remove tissue as needed. One of the perks of laser crown lengthening is that it cauterizes the tissue as it works, which is effective in reducing the amount of bleeding a patient experiences. The laser also efficiently sterilizes the area it is working in to diminish the presence of bacteria that could lead to infection.
Patients may report feeling a mild degree of swelling and some minor pain after the procedure, but it is usually minimal compared to surgical methods. To manage any pain or swelling, the patient can use a cold compress to reduce swelling. Over-the-counter pain medication may also be helpful.
It is important that patients who have had laser crown lengthening still take care of their teeth after the procedure by gently brushing the teeth.
Until the gums have healed completely from the procedure, the patient should avoid particularly hard or crunchy foods that could irritate or damage the gums, which would extend the timeline for healing.
If your dentist has told you a tooth needs more length before a crown can go on, or your gums cover more of your teeth than you would like, call 713-723-7200 or request an appointment. We see patients from Meyerland, Bellaire and across southwest Houston.
Frequently Asked Questions
Can crown lengthening fix a gummy smile?
Often, yes, and this is one of the most common reasons people ask about it. If your teeth look short because more gum shows than you would like, reshaping the gumline exposes more of the natural tooth already there. It is worth knowing that not every gummy smile is caused by the gums. Sometimes it comes from the lip or the jaw, and in those cases crown lengthening is not the answer. An examination is what tells them apart.
Do my gums grow back over the tooth afterward?
No. Once the tissue has healed at its new level it stays there, which is what makes the result lasting. That is also the reason to take the decision seriously and be sure about the shape you want before anything is done. We will talk through the plan and show you what is intended first.
How long does healing take?
The gum tissue itself settles fairly quickly, but the final shape takes longer to establish, and that matters if a crown or veneer is going on afterward. We usually allow time for the gumline to stabilize before taking the final impression, because fitting restorative work to gums that are still settling is how you end up with a visible mismatch later. Dr. Tummala will give you the timeline for your case.
Is crown lengthening the same as gum contouring?
They overlap but they are not identical. Gum contouring generally means reshaping the gum tissue for appearance. Crown lengthening can involve the underlying bone as well, not just the tissue, which is what makes it suitable when a tooth needs more structure exposed so a crown has something to hold onto. Which one you need depends on whether the goal is cosmetic or structural.
How soon after crown lengthening can the crown be placed?
Not straight away. The gumline needs to reach its final position first, otherwise the crown margin can end up sitting in the wrong place as the tissue continues to settle. Waiting is the difference between a crown that looks right in five years and one that shows a line at the gum. We will schedule the restorative appointment once your gums have stabilized.