4146 Carmichael Road, Suite A
Montgomery, AL 36106
Alley & Mc Cray Endodontics
2410 L And N Dr Sw # B
Huntsville, AL, 35801-5305
Lightfoot, John P D.D.S.
4275 Lomac St
Montgomery, AL, 36106-2915
4700 Misty Ridge Cir
Birmingham, AL, 35235-8665
Apex Endodontics Pc
1932 Laurel Rd # 2c
Vestavia, AL, 35216-1945
There are two reasons why individuals need a dental crown lengthening procedure: to properly restore a tooth or to make a "gummy smile" more attractive and cosmetic dentistry can help with both.
To properly restore a tooth, several millimeters of healthy tooth structure must be available above the crest of supporting bone. However, this often is not the case when teeth are fractured, severely decayed, or worn. If enough tooth structure is not available, and the restorations are placed too close to the bone, the body reacts by creating a chronic inflammatory reaction that can create red, swollen, and sensitive gums. The gums can bleed easily and even become painful. Eventually, the inflammatory reaction may lead to bone loss around the tooth. To prevent these problems and to properly restore the tooth, the patient should have a dental crown lengthening procedure before restorative treatment.
The gummy smile may be the result of gum tissue growing over teeth that are of proper size. Often times teeth that appear small are, in fact, normal-sized teeth that are hiding under excess gum tissue. Dental crown lengthening removes the excess gum tissue and establishes a more appealing gum line.
Dental crown lengthening is a surgical procedure in which gum and bone tissue is removed from the circumference of the tooth. It is done in the dentist's office with local anesthesia (lidocaine). One or several teeth can be treated at the same time. After carefully reshaping the gum and the bone to expose healthy tooth structure, stitches (sutures) are placed to aid in healing. The stitches are usually removed five to ten days after the surgery. Follow-up appointments are scheduled as necessary to evaluate healing and plaque control. The gums should be allowed to heal for six to eight weeks before making any new restorations. At that time, the gums are more stable and better esthetic results can be achieved.
Post-surgical discomfort can last a few days and is usually minimal. It can be easily managed with commonly available over-the-counter medications such as aspirin, acetaminophen, or ibuprofen. Patients can expect to follow their normal routine the day after surgery.
Crown lengthening is recommended to properly restore a broken down tooth or to improve the esthetics of a gummy smile. If a general or cosmetic dentist does not frequently do surgeries, he or she may refer the individual to a periodontist who specializes in dental crown lengthening.
By Laura Minsk, DMD
Throughout history, dentists have tried to recreate the function and beauty of natural teeth when tooth structure has been lost. Restoring function used to be the main goal of a dentist because prior to the 1970's, dentistry lacked the proper technology to achieve fine esthetics as well as function. Dentists could only predictably offer patients a restoration that would simply "fill" the empty space. Today, dentistry has more advanced dental materials and newly developed techniques that allow dentists to offer artistically-recreated, natural-looking crowns and modern tooth bonding that would fool even the most critical eye.
Before you can understand how crowns and tooth bonding can mimic teeth you must understand why natural teeth appear as they do.
It is a common mistake for patients to think that their teeth are all one color. Your teeth are never just one color. They are a series of superimposed translucent layers of varying shades. Teeth also have different surface textures that reflect light in ways that affect the color of your teeth.
Your teeth are made up of three layers: pulp, dentin, and enamel. Each layer has a specific thickness, composition and structure. Additionally, the way light reflects off of or transluces through the layers gives you the color of your teeth. Using knowledge about the three layers of teeth allow dentists and dental technicians to recreate natural-looking dental crowns and tooth bonding.
Dental crown technicians are the true artisans in dentistry. Dentists begin the crown-making process by reducing the size of the tooth, making an impression of the reduced tooth, and selecting the proper shades of the tooth. This information is then transferred to the dental technician so a crown can be made.
Dental technicians blend science with artistic knowledge to recreate natural-looking teeth. Artistically, they use frame and reference, proportion and idealism, perspective and illusion as well as symmetry to mimic nature. Understanding the language of colors and using new dental materials and techniques has allowed the dentist to not only "fill" missing spaces but create cosmetic dentistry artwork from crowns and tooth bonding as well.
By Benjamin O. Watkins, III, DDS