A thorough clinical and radiographic examination during the initial consultation will be done to confirm the position of the bone and gums relating to the tooth and or restoration. The prosthodontist or dentist would have most likely referred you to the periodontist to asses you for the surgical procedure.

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Once you’ve decided to have the procedure done, you don’t have to fast or change your diet on the day before or the day of the procedure. All you have to do is show up. 

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However, if sedation or general anaesthetic is being done you should stop eating or drinking at least 6-8 hours before the procedure and you do need to arrange a ride to and from your appointment. You’ll be given medications for pain and discomfort that may make it unsafe for you to drive, so you’ll need to ride home with a friend or use a car service.

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Please discuss your chronic medications and vitamins (especially omega 3 & 6) taken with your periodontist to make sure that you do not have any excessive bleeding risk. 

Now, we'll go over what you can expect in surgery so that you're fully prepared and confident as you go into your tooth exposure procedure. Here's a general sequence of events that take place during surgery after the area is numbed:

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1. An incision is made in the gum tissue, and a flap of tissue is gently lifted to expose the underlying bone and tooth. In cases where there is thick oversized gum, an incision is made to cut off any excessive gum tissue.

2. Once the tooth root and bone is exposed, the bone is contoured and height reduced to expose enough tooth structure.

3. The gum flap is repositioned and sutured in place.

4. A 2 week follow up to make sure healing is on track.

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The duration of the procedure depends on how many teeth need to be crown lengthened. If you only need one tooth crown lengthened, it usually takes about an hour. If you need multiple teeth lengthened in different areas of your mouth, it could take longer.

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Does clinical crown lengthening hurt?

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You’ll be numb during your surgery, so you won’t feel anything during the procedure. You’ll probably have mild soreness after your procedure, but your periodontist will give you medications and post-surgical instructions to help minimise your discomfort. Sensitivity to hot and cold beverages and food may occur within the first few days after the procedure.

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What’s the surgical tooth exposure recovery timeline?

Your surgeon will probably want to check on your healing two weeks later, whereafter you will be recalled again at 4 - 6 weeks after the procedure.

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During this time, they’ll provide you with specific instructions. In general, here’s what you can expect:

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The first day

Following your procedure, you’ll experience some bleeding, swelling and discomfort. To manage these side effects, take all medications exactly as prescribed by your surgeon. Get lots of rest and avoid strenuous activities.

Eat soft, cool foods, such as yogurt, pudding or smoothies. Avoid hot and very cold beverages and food.

Keep the surgical area clean using an antibacterial mouthwash. Don’t brush or floss directly on the surgical site, as this can damage it and cause pain. (You can brush and floss your other teeth as your comfort level allows.)

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The first week

Bleeding should subside within the first 24 hours to 48 hours. Swelling will continue for three to four days. You may also develop bruising during this time. These side effects are normal and should subside within the week. Continue taking all medications as prescribed.

You can incorporate more soft foods into your diet as you’re able, including things like eggs, pasta, fish and cooked vegetables.

Gently brush your teeth near the surgical site, but don’t brush directly on your gums. Don’t brush or floss around the surgical site until your surgeon says it’s safe.

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The second week

Swelling and bruising should begin to fade, and your comfort level should continue to improve. Ask your surgeon when it’s safe to begin decreasing your medication dosage.

As your comfort level improves, you can incorporate more solid foods. However, you should still avoid hard, crunchy or spicy foods until your surgeon clears you.

Once your surgeon says it’s safe to do so, you can resume normal brushing and flossing.

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How long does it take to recover from a clinical crown lengthening?

Every person heals differently. But on average, clinical crown lengthening recovery takes one to two weeks. If you had multiple areas treated at once, recovery might take a little longer. Your periodontist can tell you what to expect.

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Final positioning and maturation of the gum tissues can be expected 6-12 weeks after the procedure has been done.

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When can I resume normal routines?

You should avoid exercise, heavy lifting and other strenuous exertions for at least the first week. These activities increase your heart rate and can lead to more discomfort, bleeding and swelling. Be sure to clear it with your surgeon before you resume these activities.

Most people can return to work or school in one to two days.

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Bleeding

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• It is normal to expect some minor bleeding, even though it will be sufficiently controlled during the procedure.

• Any provided gauze should be kept in your mouth for about 1-2 hours, but you can replace it as needed.

• If bleeding continues, you can manually apply pressure or gently bite down on the gauze over the site; a wet teabag can also be used if you run out of gauze.

• It is also important to avoid intense rinsing and spitting for at least the first 24 hours in order to aid blood clot stabilization.

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Swelling

 

• You can expect to swell to some degree, this is normal and is nothing to worry about.

• The swelling usually reaches a peak in about 3-4 days so do not worry if it continues to swell.

• Use of ice packs for the first 48 hours and application of moist heat after 48 hours can minimize the swelling. Please post-operative instructions section for more detail.​

• If swelling or jaw stiffness has persisted for several days, there is no cause for alarm. This is a normal reaction to surgery. 

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Pain

 

• The amount of pain that you feel varies from patient to patient.

• Some level of discomfort is to be expected from any oral surgical procedure.

• To stay ahead of the discomfort, you should take the first dose of pain medication before the local anesthesia wears off.

• If you do have a lot of pain it may indicate an infection and should be checked.

Bruising

 

• Bruising over the face, eye, and neck can occur and is nothing to worry about.

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Sutures

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• Stitches are used to close the gums back together.

• Doctors may use either dissolvable or non-dissolvable stitches, depending on your particular case.

• The dissolvable variety will begin to disintegrate in 10 - 14 days, while the doctor will remove the non-dissolvable type at the first or second post-operative visit.

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Diet and chewing

 

• After your surgery, you will have to maintain a SOFT diet for at least 2 weeks.

• A diet of soft foods will serve to minimize trauma to the surgical sites, and this can have a positive effect on healing.

• Sometimes an even longer period of time is necessary, and the doctor will inform you if the period needs to be longer or if a liquid diet is required.

• Try to chew on sides not affected by surgery when possible.

Rinsing

 

• Mouthwash should be used regularly to lower the chances of infection,

• Do not dilute the mouthwash, it is to be used twice a day 30 minutes after you brush your teeth to prevent inactivation of the mouth rinse active ingredients by the toothpaste. Rinse your mouth for one minute then spit out.

• Do not rinse, brush, or eat for at least an hour after using mouth wash.

Medication

 

• If antibiotics are prescribed, please use it as per prescription instructions.

• Anti-inflammatory painkillers are important to reduce the level of discomfort as well as to reduce the swelling. These must be taken even if you do not feel any discomfort. Take 2 tablets/capsules immediately after surgery and then two tablets 4 – 6 hourly thereafter.

Other instructions

 

• You must eat soft foods like soups and yogurts etc. for at least one week.

• Use of ice packs for the first 48 hours can minimize the swelling.

  • The ice packs provided by our office (or bags of frozen peas) should be applied to the sides of the face continuously while awake where surgery was performed.

  • After 48 hours, ice has no beneficial effect, then moist heat can be applied to the respective area.

• No exercise for at least 7 days.

Tooth brushing & flossing/interdental brushes

 

• Avoid the surgical area with a toothbrush for 10 - 14 days.

• Start brushing gently as soon as you can.

• Brush all other areas that have not been treated and try to dislodge any food that may be sitting in the area of the surgical site.

• No flossing or interdental cleaning with brushes for 12 weeks.

 

Dentures & Prostheses

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• Partial dentures, flippers,  should not be used immediately after surgery until your post-operative appointment unless specifically instructed otherwise. When it is placed it should not touch the gums in the area of the surgery. If it does, this can cause ulceration of the wound edges and breakdown of the suture margins. 

• Temporary crowns and restorations can be done 6 weeks after the procedure and final crowns and restorations 12 weeks after the procedure, once the tissues have matured and settled.

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* This list serves merely as a guideline should you encounter any of these complications. Please call us if anything worries you. We will easily
be able to put your mind at rest.

What are the risks or complications of surgical exposure of a tooth?

Complications following clinical crown lengthening are uncommon, but they can happen. Possible complications include:

• Infection.

• Excessive bleeding.

• Damage to adjacent teeth and structures

• Post-operative sensitivity of the teeth at the surgical site, a common problem which usually settles in a matter of weeks.

• Gums possibly growing back.

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If you notice heavy bleeding, pus or anything else that doesn’t look right, contact your surgeon right away.

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IIt is important to note that as the gum heals with time, it may shrink back further. This is often why the final filling/crown is not placed until several months after the surgery. If there is an existing filling or crown on your tooth having the surgery, the edge of the filling or crown will become visible in your mouth. As the gum shrinkage will reveal more of the root of the tooth, it is very likely you will experience sensitivity to hot and cold or sweet food and drinks.

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Smoking negatively affects the outcome of this treatment.

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