Crown lengthening: who is it for?
Crown lengthening is one of the gum and dental surgery procedures carried out at the clinic of Dr Haim Aseriel in Jerusalem. It is offered to patients with a pronounced gummy smile, and to patients who need more of a tooth exposed before it can be restored. Depending on the case, the procedure is performed by the treating dentist or by a qualified specialist who treats patients at the clinic.
The procedure is planned in advance. Before surgery, the area is assessed with a clinical examination and X-rays, and the new gumline is planned to suit your teeth, your lips and your face, for a natural-looking result. Dr Aseriel, a US-trained dentist (DDS, NYU College of Dentistry), explains every step in English.
In complex restorative cases, crown lengthening is combined with gum treatment at the clinic, so that both the surgical and the restorative sides of the treatment are planned together.
What is crown lengthening (gum contouring) and why is it done?
Crown lengthening is a surgical procedure that exposes more of the natural tooth structure by removing a controlled amount of gum tissue and, sometimes, bone.
The crown lengthening procedure is needed in several clinical situations. The most common are: exposing more tooth surface before a restoration such as a dental crown or a veneer; correcting a "gummy smile" (too much gum showing when you smile); and treating a tooth that has broken below the gumline.
In restorative dentistry, crown lengthening becomes necessary when there is not enough sound tooth exposed to hold a crown or another restoration. Without enough exposed tooth, the restoration may invade the "biologic width", the zone of gum attachment around the tooth. Encroaching on this zone can lead to chronic gum inflammation, gum recession and, in the long run, even loss of the tooth.
From an esthetic point of view, gum contouring is a key element of the smile. A balanced gumline is symmetrical, continuous and in harmony with the edges of the teeth. When the gumline sits too low on the teeth or is uneven, the teeth can look short and the smile less balanced; esthetic crown lengthening can then restore a better proportion between gums and teeth.
Benefits of crown lengthening and gum contouring
Crown lengthening offers more than a visual improvement.
Function
The procedure allows a damaged tooth to be restored properly, which helps it work normally again when you chew. When a tooth has broken or decayed below the gumline, crown lengthening gives access to the damaged area and can make a restoration possible where the alternative would be extraction and replacement with a dental implant or a dental bridge.
Appearance
In a gummy smile, esthetic crown lengthening rebalances the length of the visible teeth against the gums, which can noticeably change how the smile looks.
The crown lengthening procedure, from planning to stitches
Crown lengthening starts with a thorough assessment and a treatment plan built around your needs. Careful planning is key, which is why time is spent on the initial examination and on explaining the procedure. The first stage includes X-rays and an analysis of how the teeth, gums and lips relate, to decide precisely how much tissue to remove and where.
The surgery itself is done under local anesthesia: you are awake and the area being treated is numb. The gum is opened precisely, the excess tissue is removed and, when needed, the supporting bone is reshaped. At the clinic, the procedure is done with the conventional surgical technique, without a laser.
At the end, the area is stitched; depending on the type of suture, the stitches are removed at a follow-up visit or dissolve on their own. The next restorative step, such as fitting a crown, only starts once the tissues have stabilized: in studies, the gumline may shift slightly after surgery, mainly during the first three months (Pilalas et al., 2016).
Because the procedure depends on each situation, an examination is needed first to check whether crown lengthening suits your case; you then receive a detailed treatment proposal.
How is crown lengthening surgery performed?
Crown lengthening surgery is carried out when more of the natural tooth needs to be exposed. It follows three main steps.
Local anesthesia and a precise incision
The area is numbed with local anesthesia. Effective anesthesia allows the procedure to be done precisely while keeping you comfortable. Once it has taken effect, a precise incision is made in the gum to expose the bone around the tooth.
Controlled removal of tissue
A controlled amount of gum tissue, and sometimes a little of the supporting bone, is carefully removed according to the esthetic and functional needs of the case. The goal is a harmonious gumline and the right tooth length for your mouth.
Stitches and healing
The tissue is gently stitched. Discomfort usually eases within the first few days, but the tissues keep maturing and settling for several months (Lanning et al., 2003). During this period you receive detailed aftercare instructions, and the rest of the treatment plan follows the pace of your healing.
Possible risks and discomfort
- Swelling, pain and slight bleeding in the first days, especially when a flap is raised and stitched (Yaneva et al., 2026).
- Tooth sensitivity to cold and heat: the most common complication, in about 5% to 6% of cases (Yaneva et al., 2026).
- A shifting gumline in the first months: the gum may grow back slightly over part of what was exposed, which is why the final crown waits (Pilalas et al., 2016).
- Gum recession and "black triangles" between teeth, mainly with thin gums; smoking and diabetes increase the risk of complications.
Laser crown lengthening: what the evidence says
Research comparing lasers with the conventional surgical technique in crown lengthening is still limited (Pilalas et al., 2016), so a laser is not considered better by default.
The clinic does not use a laser: crown lengthening is done with the conventional surgical approach, which also allows the bone to be reshaped when needed.
Restorative and esthetic crown lengthening
Restoring a tooth is one of the most common reasons for crown lengthening. When a tooth breaks below the gumline, or when decay spreads under the gum, sound tooth structure has to be exposed so that the tooth can be restored properly. Crown lengthening exposes enough healthy tooth to serve as a solid base for the final restoration, whether a crown, a bridge or another restoration.
For a fracture below the gum, the depth of the break is assessed to decide whether the tooth can be restored at all. The considerations include how much exposure is needed, how much bone would have to be removed and the ratio between root length and crown length after surgery. The aim is to keep the natural tooth whenever that is reasonable.
Beyond function, crown lengthening is also an esthetic solution for a "gummy smile". Esthetic crown lengthening changes the ratio between the visible length of the teeth and the gums, for a more harmonious smile. It calls for a good understanding of cosmetic dentistry and of the anatomy of the mouth.
The new gumline is planned for each patient, taking into account the proportions of the teeth, the position of the upper lip when smiling and the overall shape of the face. A Digital Smile Design (DSD) simulation shows the expected result before treatment starts.
Esthetic crown lengthening is not suitable for every gummy smile. In some cases the cause is excess growth of the upper jaw or an overactive upper lip, and a combination of treatments or a different solution may then be recommended.
Examination, treatment plan and price quote
detailed and personalized
During the consultation, Dr Haim Aseriel examines your teeth, explains all the options and gives you a transparent price quote, with no obligation. The clinic is at 12 HaTnufa Street, Jerusalem.
Aftercare and follow-up after crown lengthening
After crown lengthening, healing and follow-up are essential for a lasting result. Attend every follow-up visit, so the dentist can check that healing is on track and that the esthetic and functional result meets expectations. Some swelling in the treated area is normal in the first days and usually goes down within a few days. You may also feel mild pain: ask your dentist or pharmacist which pain reliever and which dose are right for you.
Avoid hard or very hot food for the first few days, and rinse gently with the solution your dentist recommends. Do not brush the treated area until your dentist says so; then go back to gentle brushing with a soft toothbrush. Avoid smoking and alcohol while you heal, as they can slow healing and raise the risk of infection. Even after the discomfort has gone, the tissues keep settling for several months and the gums may change slightly in appearance.
6months
Until the tissues around the tooth returned to their original dimensions, in a follow-up study (Lanning et al., 2003)
Follow-up visits check the gums, look for any sign of infection or unwanted recession, and monitor overall healing.
The first check-up is usually scheduled shortly after surgery, as after any gum surgery, and the next ones follow the progress of healing. Depending on the case, X-rays may be taken to make sure the supporting tissues are healthy and the teeth are stable.
When crown lengthening is done to restore a tooth, for example before a crown, the restorative phase has to wait. This time lets the gums settle in their new position: in studies, the gumline kept moving slightly during the first months, and in one of them it had still not fully stabilized after 6 months (Deas et al., 2004). The waiting time is set by the treating dentist according to the position of the tooth (longer in the visible front area) and your own healing.
Crown lengthening cost: what affects the price?
The clinic does not publish a price list for crown lengthening, because the cost depends on the case. The price mainly depends on the number of teeth involved, on whether only gum tissue or also bone has to be removed, and on whether the area is in the visible front of the mouth, where planning is more detailed. The crown or other restoration that follows is a separate step of the treatment plan.
After the examination you receive a written quote, with the expected treatment time and healing period. Itemized receipts are provided so that you can submit them to your insurer; reimbursement depends on your policy, so check with your insurer beforehand.
Gum contouring: what planning includes
Gum contouring through crown lengthening aims to improve the look of the smile and to allow a sound restoration, and it is adapted to each patient. The assessment includes a clinical examination and photographs or X-rays as needed, to understand your smile and plan the balance between lips, gums and teeth.
At the consultation, the recommended plan is presented with an explanation of each stage and of the expected result. Alternatives, the pros and cons of each approach and all your questions are discussed in English. Looking for crown lengthening near you? The clinic is at 12 HaTnufa Street in Talpiot, south Jerusalem; hours: Sun 8:00–19:00 · Mon 9:00–19:00 · Tue–Wed 9:00–21:00 · Thu 8:30–21:00 · Fri 8:00–14:00. You can also read patient reviews or learn more about Dr Haim Aseriel.
Crown lengthening: frequently asked questions
Crown lengthening is a minor gum procedure that exposes more of a tooth by removing a controlled amount of gum tissue and, sometimes, a little bone. It is done before placing a crown when not enough tooth is visible, when a tooth has broken below the gumline, or to correct a "gummy smile".
Crown lengthening surgery is performed under local anesthesia. The gum tissue is opened, a controlled amount of tissue (and sometimes a little of the supporting bone) is removed, and the area is stitched. How much tissue is removed is planned in advance from the examination and X-rays.
After crown lengthening, discomfort and swelling usually ease within the first few days, but the tissues keep settling for months: in studies, the gumline may shift slightly, mainly during the first three months. That is why the final crown is placed only once the tissues have stabilized, and usually after a longer wait in the visible front area.
After crown lengthening, avoid hard or very hot food for the first few days, do not brush the treated area until your dentist says so, then brush it gently with a soft toothbrush. Avoid smoking and alcohol during healing, and ask your dentist or pharmacist which pain reliever and dose are right for you.
Esthetic crown lengthening is not suitable for every gummy smile. Sometimes the cause is excess growth of the upper jaw or an overactive upper lip, and a combination of treatments or a different approach is then needed. An examination is required to find the cause.
Sources
- Lanning SK et al., Journal of Periodontology, 2003 – View the study
- Deas DE et al., Journal of Periodontology, 2004 – View the study
- Pilalas I et al., Journal of Clinical Periodontology, 2016 – View the study
- Yaneva B et al., Dentistry Journal (Basel), 2026 – View the study
