When a tooth breaks off near the gumline, it's easy to assume the tooth is lost for good. Usually, it isn't. Crown lengthening in San Diego, CA gives your dentist the extra tooth structure needed to place a strong crown, filling, or veneer, and the same procedure can even out a gum line that hides too much of your smile. At Radiant Smiles Dentistry, we plan the surgical step and the final restoration together, so the result looks natural and lasts.
Crown lengthening is a minor surgical procedure that removes excess gum tissue, and sometimes a small amount of bone, to expose more of the natural tooth so a crown, filling, or veneer has solid structure to grip, or so a high gum line looks more balanced.
Dentists perform it for two main reasons: to create enough tooth structure to hold a crown or filling, and to reshape a gum line that makes teeth look short. Both goals often overlap in the same mouth, and the exam tells us which one is driving your case.
Each version has a name. Functional crown lengthening is done so a damaged tooth can be restored. Esthetic crown lengthening addresses a "gummy" smile where healthy teeth simply look stubby.
Your dentist can't just cement a crown over a tooth that has broken at the gumline, and there's a clinical reason why. Every tooth needs a small band of healthy tissue between the edge of a restoration and the underlying bone, often called biologic width. Crowd that space, and the gums stay irritated, bleed easily, and the crown margin never seals well. Crown lengthening restores that breathing room.
We complete most cases in one visit using local anesthesia, and you go home the same day.
Most of the time, the practical benefits matter more than the cosmetic ones. When there isn't enough tooth above the gumline, a crown has nothing to hold onto, and even a well-made restoration will loosen or leak. Crown lengthening solves that problem at the source.
The procedure makes a few things possible:
Keeping your own tooth root also preserves the bone around it and keeps neighboring teeth from shifting. Our team looks at both the tooth in front of us and how it affects everything next to it.
Crown lengthening usually takes one appointment of about 60 to 90 minutes. Your dentist numbs the area, makes small incisions to reposition the gum tissue, recontours a bit of bone if needed, then closes the site with sutures. Soft tissue heals in one to two weeks before your final crown is made.
Here's how the visit goes:
Treating several teeth at once takes longer than a single tooth. Numbing wears off in a few hours, and most people manage the first day or two with over-the-counter pain relievers and an ice pack.
You're likely a good candidate if a tooth has broken, worn down, or decayed at the gumline and there isn't enough structure left to hold a crown. Patients bothered by short-looking teeth or gums that show too much when they smile are often candidates as well.
Healthy tissue matters, too. Crown lengthening works best when your gums are free of active infection and the bone around the tooth is strong. If gum disease is present, we treat that first and let the tissue settle before any reshaping is planned.
Sometimes the honest answer is a different treatment. When a tooth is fractured deep into the root or lengthening would leave too little support, an extraction with a tooth replacement option like an implant gives a better long-term result. We'll tell you when that's the case, and we won't push you toward surgery that won't last.
Usually a strong candidateMay need a different plan firstTooth broken or decayed right at the gumlineActive gum disease or infection presentNot enough structure to hold a crownFracture extending deep into the rootTeeth that look short, uneven gum heightsLimited bone support around the toothHealthy gums and stable bone levelsRoot canal or periodontal therapy still needed
We'll look closely at your health history, too. Smoking slows healing, uncontrolled diabetes affects tissue recovery, and certain medications, including blood thinners and some bone medications, change how we approach surgery. Bring your medication list when you come in.
Crown lengthening is only half the work. The crown that follows has to fit the new gum line perfectly, which is why we design the final restoration before the surgical step rather than after. You get one team and one plan in our cozy, modern office.
Dr. Raymond Wright III, DDS, practices cosmetic and general dentistry and earned his DDS from the University of Illinois-Chicago in 2005. He also holds a BS and MS in Biological Sciences-Microbiology from Illinois State University. After dental school, he completed a post-graduate mentorship with two MAGD doctors, and that training shaped the conservative, detail-focused way surgical and restorative cases are handled here.
Radiant Smiles Dentistry holds membership in the American Dental Association (ADA), the Academy of General Dentistry (AGD), the California Dental Association (CDA), and the San Diego County Dental Society (SDCDS).
Precision depends on good imaging. Digital panoramic imaging, external bitewing equipment, and an FDA-approved decay detection camera let us see how far decay reaches before we plan tissue and bone contouring.
We think about comfort, too. Netflix, warm towels, and a beverage station are part of the visit, and happy patients regularly describe a no pressure sales approach to extra services. Nothing gets added to your plan without a clear explanation of why it's needed and what it costs. We serve happy patients throughout San Diego, 4S Ranch, and Dove Canyon.
You shouldn't feel pain during the procedure, because the area is fully numbed with local anesthesia before any tissue is touched. Afterward, expect mild soreness and some swelling for a few days, which most people manage with over-the-counter pain relievers and cold compresses. Call us if discomfort increases instead of easing.
Soft tissue typically heals within one to two weeks, and sutures come out at a follow-up visit about 7 to 10 days later. Bone takes longer to firm up, generally 6 to 12 weeks, which is why the permanent crown waits until the gum line is stable. Most people return to work or school the next day.
Cost depends on how many teeth are treated and whether bone recontouring is part of the plan, so a single tooth costs less than reshaping across several. Coverage varies by plan, and functional cases done to restore a tooth are handled differently than purely cosmetic ones. Our team verifies your benefits and gives you a written estimate before treatment begins.
When the procedure is performed properly and the bone is contoured to support the new tissue level, results are stable long term. Gum tissue reattaches at its new position rather than creeping back over the tooth. Good home care and regular cleanings keep that tissue healthy.
Some esthetic cases that involve soft tissue only can be reshaped with a laser. Once bone levels need adjusting, and that's common when a tooth is broken at the gumline, a surgical approach is required to reach and recontour the bone. We'll tell you which one your case calls for after imaging.
Stick with soft foods for several days, like yogurt, eggs, smoothies, pasta, and soup, and chew away from the surgical site. Skip anything crunchy, spicy, or very hot while the tissue is tender, and avoid straws early on. Rinse gently as directed rather than swishing hard.
No one should have to hide their smile or lose a tooth that can still be saved. If a tooth has broken near the gumline or your gums cover more of your teeth than you'd like, our team at Radiant Smiles Dentistry will examine the area, review your imaging with you, and explain your options in language that makes sense.
New patients are always welcome, and our team will work around your schedule to find a visit time that fits, so you can look and feel your best sooner. Before treatment starts, we'll go over your insurance benefits and payment options so the estimate doesn't surprise you.
Call (858) 330-7665 or request your visit online. Our San Diego office at 16918 Dove Canyon Rd Unit 209, San Diego, CA 92127 welcomes patients from across San Diego, 4S Ranch, and Dove Canyon.
Ready to get a radiant smile? Schedule now, and let's get you back to smiling through life again.