Periodontics

Crown Lengthening in Los Angeles

Sometimes a crown cannot be fitted until there is more tooth to fit it to.

Crown lengthening adjusts the gum line to expose more of the natural tooth. Smile LA Downtown Modern Dentistry uses it mostly as the step that makes restorative work possible, and occasionally for how a smile looks.

Restorative

The usual reason: making a restoration possible

A crown needs enough tooth structure above the gum to grip. Where decay or a fracture has taken the tooth down close to or below the gum line there is nothing for the restoration to hold, and seating a crown against what is left would mean a margin that cannot be sealed or kept clean. Crown lengthening exposes more of the natural tooth so the crown can sit against solid structure. That improves the final result as well as making it possible, because a restoration that fits at the margin is a restoration that lasts — and in some cases it is the difference between keeping the tooth and losing it. Bone is sometimes adjusted as well as gum, depending on where the tooth has broken down to.

  • Deep decay Where the remaining tooth sits at or below the gum.
  • A fracture below the gum line Common after a break, and the reason some teeth are otherwise unrestorable.
  • Before a large restoration Ensuring a proper fit for crowns or other restorations.
Cosmetic

The other reason: a gum line that sits too low

Where the teeth are the right size but too much gum covers them, lengthening exposes their true proportions. That overlaps with gum contouring, and the difference is what is being adjusted: contouring reshapes tissue, lengthening changes how much tooth is exposed — which sometimes involves bone as well as gum.

Which one you need

It depends on why the gum is where it is, and that is what the examination establishes. The two get conflated because they look similar from the outside and are different procedures with different purposes.

Related

Gum disease, where crown lengthening appears among the periodontal treatments, and soft tissue grafts, which is the opposite problem.

A patient standing with Dr. Kourosh Yousefzadeh after treatment

Crown Lengthening FAQ

Why would I need crown lengthening?
Most often because there is not enough tooth above the gum for a crown to grip — after deep decay or a fracture below the gum line.
Is it the same as gum contouring?
No. Contouring reshapes gum tissue for appearance. Lengthening changes how much tooth is exposed, and can involve bone as well as gum.
Can it fix a gummy smile?
It can, where the teeth are well proportioned but too much gum covers them.
Does it happen before the crown?
Yes — it is the step that makes the restoration possible, so it comes first.
Dr. Kourosh Yousefzadeh seated in the office lobby beside a white Samoyed
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Dr. Kourosh Yousefzadeh, D.D.S.
Founder of the practice, treating patients at the Financial District office.
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