Dr. Theo Katsaros
Lead periodontist
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Background
What is crown lengthening?
Crown lengthening is a periodontal procedure that reshapes the gum tissue and underlying bone around one or more teeth to expose more of the natural tooth structure above the gum line.
The procedure serves two distinct but equally important purposes. In an aesthetic context, it is used to correct a gummy smile, where excess gum tissue covers too much of the tooth surface, making the teeth appear short or disproportionate. By carefully removing and recontouring that tissue, crown lengthening creates a more balanced tooth-to-gum ratio that many patients find significantly improves the overall appearance of their smile.
In a restorative context, crown lengthening is performed to give your dentist adequate access to place a crown or other restoration correctly. When a tooth is broken, decayed, or has existing restorations that extend deep below the gum line, there may not be enough tooth structure visible above the tissue for a crown to attach to securely. Crown lengthening exposes that additional structure, ensures the margin of the restoration sits in a position that can be properly fitted and sealed, and keeps the restoration away from the bone for a predictable long-term result.
In both cases, the procedure involves adjusting the level of both the gum tissue and the bone around the tooth to establish a new, stable gum-to-tooth relationship.
When is crown lengthening recommended?
Crown lengthening may be the right treatment for you if:
You have a gummy smile where excess gum tissue covers a significant portion of your teeth, making them look shorter or less proportional than you would like.
Your teeth need crowns or deep restorations that extend below the gum line, and there is insufficient tooth structure accessible above the tissue for a secure, well-fitted restoration.
A tooth has fractured or decayed at or below the gum line and your dentist needs more tooth structure exposed before a crown or other restoration can be placed.
You find everyday brushing and flossing difficult because excess gum tissue makes it hard to clean along the gum line effectively, allowing plaque to accumulate in areas that are hard to reach.
You experience discomfort during oral hygiene because toothbrush bristles or floss aggravate excess gum tissue, causing redness or bleeding that makes consistent home care uncomfortable.
During your consultation, we will assess your gum tissue, bone structure, and the specific goals of your treatment to determine whether crown lengthening is the most appropriate course of action.
Crown lengthening for a more proportional smile
For patients seeking a cosmetic improvement, crown lengthening offers a lasting and highly effective solution to a gummy smile. When the gum tissue sits too low on the tooth, it can make even healthy, well-shaped teeth look stubby or unbalanced. No amount of whitening or other cosmetic treatment will address that underlying proportion issue.
By carefully removing excess gum tissue and recontouring the bone beneath it, crown lengthening establishes a new gum line that allows more of each tooth to show. The result is a smile where the teeth and gums are in better harmony, and where the natural shape and length of the teeth can be appreciated fully.
During the planning stage, we work with you to determine the gum line that will best suit your facial features and smile goals. You will have a clear understanding of the expected outcome before any treatment begins.
Crown lengthening to support restorative work
When crown lengthening is performed for restorative purposes, it is an important step in ensuring that a crown or filling placed by your dentist will fit correctly, seal properly, and remain stable for years to come.
A restoration that sits too close to the bone, or whose margins are inaccessible because of overlying gum tissue, is more difficult to fit precisely and harder to keep clean. Over time, that inaccessibility allows plaque and calculus to accumulate at the margin, increasing the risk of recurrent decay and gum disease around the restoration.
Crown lengthening addresses all of these issues by exposing more of the tooth structure, creating space between the restoration margin and the bone, and allowing both your dentist and your hygienist better access to the area for fitting, adjustment, and ongoing maintenance.
Our process
Crown lengthening process at Bloor-Yorkville Periodontics
Step 1: Consultation and treatment planning
We begin with a thorough examination of your teeth, gums, and bone structure. We review your dental and medical history and take digital X-rays to assess the level of the bone relative to the gum tissue and the tooth.
For patients seeking aesthetic crown lengthening, we take time during the planning stage to discuss the smile proportions you are hoping to achieve and map out the new gum line that will best suit your teeth and facial features. For restorative cases, we coordinate with your treating dentist to ensure the crown lengthening procedure creates exactly the access and tooth exposure needed for your planned restoration.
You should leave your consultation with a clear picture of what the procedure involves, what results to expect, and what your recovery and follow-up timeline should look like.
Step 2: Preparing for your procedure
Before we begin, we administer a local anesthetic to fully numb the treatment area. The procedure takes approximately one hour, and you should not feel pain at any point during it, though some mild pressure is normal.
For patients who feel anxious about the procedure or whose treatment is more extensive, we can discuss comfort options at your consultation to ensure you feel relaxed and well cared for throughout.
Step 3: Reshaping the gum and bone
Your periodontist makes small, precise incisions in the gum tissue to access both the gum and the underlying bone. The gum tissue is carefully removed and reshaped to expose the desired amount of tooth structure, and the bone is contoured as needed to establish a stable new gum-to-tooth relationship that will be maintained long term.
Working with both the soft tissue and the bone is what distinguishes a crown lengthening procedure from simpler gum reshaping. Recontouring the bone ensures the result is lasting rather than temporary, as gum tissue that has been reshaped without addressing the underlying bone tends to grow back over time.
Step 4: Closing and suturing
Once reshaping is complete, the gum tissue is repositioned and sutured carefully into place. The sutures hold the tissue in its new position while healing begins.
Step 5: Healing and follow-up
You will be seen again one to two weeks after your procedure to assess your healing and remove your sutures. Most patients heal comfortably over the following weeks with straightforward aftercare.
For patients undergoing crown lengthening in preparation for a crown or restoration, your dentist can typically proceed with the restorative work approximately six weeks after your procedure, once the gum tissue has healed and stabilized in its new position.
Step 6: Aftercare instructions
Before you leave, we provide you with clear aftercare instructions covering what to expect in the days following your procedure, how to keep the area clean during healing, dietary recommendations, and what signs would prompt you to contact us. Our team is available to support you throughout your recovery.
I had a crown lengthening procedure done. I've never had surgery before and was scared but she was reassuring, confident and very knowledge! Results are amazing. Would recommend! Staff is kind too.
Maude
Google Review
Your periodontal specialists
Why choose Bloor-Yorkville Periodontics in Toronto for crown lengthening?
At Bloor-Yorkville Periodontics, we understand that learning you need crown lengthening can feel daunting. We are committed to making that process as informed, comfortable, and clinically effective as we can.
Specialist periodontal expertise - Crown lengthening requires both surgical precision and an understanding of how gum and bone tissue respond and heal over time. As periodontists, this is the work we are specifically trained for, and we bring that depth of knowledge to every procedure.
Aesthetic judgment alongside clinical skill - For patients seeking a more proportional smile, the outcome depends not only on surgical technique but on a careful eye for facial aesthetics and smile design. Our periodontists are recognized among Toronto's leading specialists in this area, with a reputation built on results that look natural and complement each patient's individual features.
Coordinated restorative care - For patients undergoing crown lengthening ahead of restorative dental work, we work closely with your treating dentist to ensure the procedure creates precisely the access and tooth exposure needed for your planned crown or restoration.
Patient-centred approach - From your first consultation through to your final follow-up, we take the time to understand your goals, explain your options clearly, and ensure you feel informed and comfortable at every stage of your treatment.
Conveniently located in Toronto - Our practice is easy to reach for your consultation, your procedure, your suture removal appointment, and any follow-up care needed during your recovery.
Gum disease does not resolve on its own, and delays in treatment allow it to advance to stages that are significantly more difficult and costly to manage. If uncertainty or anxiety has prevented you from seeking care, our team in Toronto is here to help you take that step with confidence.
FAQ
Frequently asked questions about crown lengthening
How do I know if I need crown lengthening?
If your teeth appear short or your gums seem to cover a disproportionate amount of your tooth surface when you smile, aesthetic crown lengthening may be worth exploring. If your dentist has told you that a tooth needs a crown but there is not enough tooth structure accessible above the gum line, or that existing decay or damage extends below the gum tissue, restorative crown lengthening is likely a necessary step before that work can proceed. A consultation with our team will give you a clear answer based on a thorough assessment of your specific situation.
Is crown lengthening painful?
The procedure is performed under local anesthetic, so the treatment area is fully numb throughout. You should not feel pain during the procedure itself, though some mild pressure is normal. In the days following your appointment, some tenderness and swelling are to be expected, and we will give you clear instructions on managing your recovery comfortably. Most patients find the experience more straightforward than they anticipated.
Will my gums grow back after crown lengthening?
When crown lengthening is performed correctly by a periodontist who addresses both the gum tissue and the underlying bone, the result is intended to be lasting. Recontouring the bone is the key step that prevents the gum tissue from returning to its original level over time. Gum reshaping that involves only the soft tissue without addressing the bone is more likely to result in regrowth, which is one of the reasons this procedure is best performed by a periodontal specialist.
How long does it take to recover from crown lengthening?
Most patients are comfortable resuming light daily activities within a day or two of their procedure. Sutures are typically removed at a follow-up appointment one to two weeks after surgery. Full tissue healing and stabilization takes approximately six weeks, which is when restorative dental work such as crown placement can safely proceed. We will give you a complete picture of your expected recovery timeline at your consultation.
Will crown lengthening improve my oral hygiene?
For patients with excess gum tissue that makes it difficult to clean thoroughly along the gum line, crown lengthening can make a meaningful difference to the effectiveness of daily brushing and flossing. By removing overlying tissue and exposing more of the tooth surface, the areas where plaque tends to accumulate become more accessible, which supports better home care and can reduce the risk of decay and gum disease developing in those hard-to-reach spots.
I had a clinical crown lengthening/ periodontal surgery done. They did an excellent job from the initial consultation throughout the entire procedure. My gums seem to heal well and I wish I had gone earlier. A shout out to her dental hygienist - I could feel the difference while and after the cleaning - she is amazing! Thank you to the entire team. I felt I was in good hands.
Christian Mueller
Google Review
