Crown Lengthening: Accessing Hidden Tooth Structure
Crown lengthening is a surgical procedure that removes gum tissue, bone, or both to expose more of the tooth's clinical crown. The procedure serves two distinct purposes. Functionally, it provides access to tooth structure that is broken, decayed, or fractured below the gum line — enabling the placement of a crown or filling on a tooth that would otherwise be unrestorable. Aesthetically, it corrects a "gummy smile" where excessive gum tissue covers the upper teeth, making them appear short.
At ADSC, functional crown lengthening is performed when subgingival tooth damage extends into the biologic width — the 2 to 3 mm zone of attachment between the gum tissue and bone that must not be violated by a restoration margin. Placing a crown margin within this zone causes chronic inflammation, bone loss, and eventual treatment failure. By removing tissue and recontouring bone to reestablish the biologic width below the damage, the tooth becomes restorable with a predictable long-term prognosis.
The surgical technique involves reflecting the gum tissue, recontouring the underlying bone to the planned level using rotary and hand instruments, and repositioning or removing gum tissue to establish the desired crown height. Healing takes four to six weeks before the restorative dentist places the final crown. PRF is applied to the surgical site to accelerate soft tissue closure and reduce post-operative discomfort. The result is a tooth that was saved from extraction by making it accessible for restoration.
Serving Beaverton, Aloha, Hillsboro & Washington County
Aloha Dental Specialty Center is located at 18455 SW Alexander St, Suite B, in Beaverton, Or Oregon. We serve patients from across the Tualatin Valley and greater Portland metro, including Aloha, Hillsboro, Tigard, Lake Oswego, and Tualatin. Our Beaverton office is a 5-minute drive from Aloha, 10 minutes from Hillsboro, and 15 minutes from Tigard via SW 185th Avenue.
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Intel Campuses (Ronler Acres & Jones Farm)
10 to 15 minutes via NW 185th Ave. We accommodate the schedules of tech professionals who need efficient, high-quality specialty care.
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Nike World Headquarters
About 8 minutes via SW Baseline Rd. We frequently see patients from the Nike campus for surgical and implant procedures with sedation options.
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Streets of Tanasbourne & Orenco Station
Easily accessible via US-26 and NW 185th. Local general dentists in these communities regularly refer patients to us for specialty procedures.
Why Local Dentists Refer to Us
We work as a trusted partner to general dentists throughout the Tualatin Valley. When cases require CBCT-guided planning, IV sedation, bone grafting, or other advanced procedures, local providers refer to Dr. Ostovar for his experience with implant procedures and predictable results.
We handle the procedures within our scope and coordinate closely with your general dentist for seamless continuity of care from start to finish.
Office hours: Mon–Fri 8 AM–5 PM (Thu & Fri until 6 PM), Sat 8 AM–2 PM
Understanding Your Investment
At Aloha Dental Specialty Center, we provide transparent pricing before any treatment begins. The cost of your procedure depends on clinical complexity, materials used, and sedation requirements. We walk you through every line item during your consultation so there are no surprises.
What Affects Cost:
- Clinical Complexity: Bone loss, sinus proximity, nerve involvement, or the need for grafting affects treatment planning and surgical time.
- Materials: We use research-backed implant systems, purified bone graft matrices, and high-strength ceramics from established manufacturers.
- Sedation: Options range from local anesthesia to IV sedation, each with different associated costs. We discuss the best option for your comfort and procedure.
Insurance & Financing
We accept most major dental insurance plans and file claims on your behalf. Our team verifies your benefits before treatment and submits pre-treatment estimates with clinical documentation to maximize coverage.
For out-of-pocket costs, we partner with CareCredit and Cherry for flexible payment plans. We also offer our ADSC Dental Savings Plan for patients without insurance.
Recovery & Healing Timeline
Understanding the healing process helps you plan ahead and follow post-operative instructions for the best possible outcome.
First 48 Hours
Mild swelling and tenderness are normal. Apply ice packs in 20-minute intervals and take prescribed or over-the-counter anti-inflammatory medication. Eat soft foods and avoid the surgical site when chewing.
Days 3 to 7
Swelling peaks around day three and then improves. The tissue begins closing over the surgical site. Continue with soft foods and use any prescribed antimicrobial rinse. Most patients return to normal activities during this phase.
Long-Term Healing
Surface tissue heals within two to three weeks. Bone integration and deep healing continue for three to six months. Avoid smoking, follow up as scheduled, and maintain good oral hygiene throughout recovery.
Questions during recovery? Call us at (503) 822-0096. We are available for post-operative concerns.
Biologic Width Principles in Restorative and Periodontal Integration
The biologic width — more accurately termed the supracrestal tissue attachment — comprises the junctional epithelium (approximately 0.97 mm) and connective tissue attachment (approximately 1.07 mm) that seal the sulcular environment from the alveolar bone. This approximately 2 mm zone is a physiologic constant that the body maintains regardless of restorative intervention. When a crown margin is placed within or below this zone, the body responds by resorbing bone to reestablish the biologic width at a more apical level — a process that creates chronic inflammation, unpredictable bone loss, and periodontal pocket formation. Crown lengthening preemptively addresses this by surgically relocating the bone crest to a position that provides adequate space for the biologic width plus a 1 mm sulcus depth below the planned crown margin. The target is typically 3 to 4 mm of sound tooth structure between the bone crest and the crown margin. This ensures that the restoration integrates harmoniously with the periodontal tissues rather than chronically irritating them.
Why Choose ADSC?
Crown lengthening at ADSC is performed with precise measurement of the biologic width dimensions and planned restorative margin position. Bone sounding (measuring bone level through anesthetized tissue) and radiographic assessment determine the exact amount of tissue removal needed. The surgical plan accounts for the effect on adjacent teeth — aggressive bone removal on one tooth can compromise the interproximal bone supporting the neighboring tooth. CBCT imaging is used for complex cases involving multiple teeth or proximity to anatomic structures. The restorative plan is coordinated before the surgery, ensuring the crown lengthening procedure creates exactly the tissue architecture that the final restoration requires.
Your Crown Lengthening Functional Treatment Steps
- Consultation & Exam: Comprehensive crown lengthening functional evaluation with CBCT 3D imaging at our Beaverton office.
- Treatment Plan: Our experienced dental team discusses your crown lengthening functional options, timeline, and costs. We use advanced 3D imaging and evidence-based protocols across general dentistry, endodontics, and pediatric care.
- Treatment: Procedure performed with comfort options including sedation if needed.
- Follow-Up: Post-treatment monitoring and care coordination for optimal healing.
Schedule Your Appointment Today
Book a consultation with our team at Aloha Dental Specialty Center in Beaverton, OR. Call (503) 822-0096 Office hours: Monday through Friday 8 AM to 5 PM (until 6 PM Thursday and Friday), Saturday 8 AM to 2 PM. or request an appointment online.
Related Services at Aloha Dental Specialty Center:
Dental Implants · Oral Surgery · Root Canal · Invisalign · Periodontics · Pediatric · TMJ Treatment · Sedation · Cosmetic · Emergency · Sleep Apnea
A Note from Your Dental Team
In my experience, the patients who get the best results from crown lengthening functional are those who come in with realistic expectations and follow their post-treatment instructions carefully. I’d rather spend extra time explaining what to expect than have a patient be surprised later.
“Every patient I see has a different story, a different set of concerns, and a different definition of what ‘success’ looks like. That’s why I don’t believe in one-size-fits-all treatment plans. When you come in for a consultation, I’ll listen first, examine second, and recommend third.
I also won’t recommend a procedure you don’t need. If your tooth can be saved with a filling instead of a crown, I’ll tell you that. If watchful waiting is appropriate, I’ll explain why. My job isn’t to sell treatment — it’s to give you my honest clinical judgment so you can make an informed decision.
If you have questions about whether this treatment is right for you, or if you’ve been told you need this procedure by another dentist and want a second opinion, call us at (503) 822-0096. We’re happy to take the time to explain everything — no rush, no pressure.”
— Dr. Merat Ostovar & Dr. Jovan Gvozden | Aloha Dental Specialty Center, Beaverton, OR
I know many patients feel anxious about dental procedures — you’re not alone in that. What I hear most often after treatment is: “That was so much easier than I expected.” We’re here to make this as comfortable as possible for you.
Are You a Candidate for Crown Lengthening Functional?
Most patients in good general health are candidates for crown lengthening functional. However, certain factors may affect your eligibility or require modifications to the treatment plan:
- Medical conditions: Uncontrolled diabetes, autoimmune disorders, or blood-thinning medications may require coordination with your physician before treatment.
- Bone quality: For crown lengthening functional involving the jawbone, adequate bone density is essential. A CBCT 3D scan during your consultation determines this precisely.
- Smoking: Tobacco use significantly impairs healing. We strongly recommend quitting 2-4 weeks before and after any surgical procedure.
- Age: There is generally no upper age limit. What matters is your overall health, not your age. We have successfully treated patients in their 80s and 90s.
The only way to know for certain is a consultation with our team with a board-certified endodontist. Call (503) 822-0096 to schedule your evaluation — we’ll tell you honestly whether this is the right treatment for your situation.
Typical Healing Timeline:
Days 1-3: Initial healing, mild swelling managed with ice and medication. Days 4-7: Swelling subsides, gradual return to normal diet. Weeks 2-4: Soft tissue heals completely. Months 2-6: Bone remodeling and full integration (for surgical procedures). Individual recovery varies — we provide detailed post-op instructions specific to your procedure.
For additional clinical information, visit the American Dental Association (ADA).
Reviewed by Dr. Walied Eldomiaty, DDS, Periodontist — March 2026. Clinical information on this page reflects current evidence-based dental practices.
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Frequently Asked Questions
If the tooth is broken, decayed, or fractured below the gum line, there is not enough exposed tooth structure for a crown to grip. Additionally, placing a crown margin too close to the bone causes chronic inflammation and eventual failure. Crown lengthening exposes more tooth and reestablishes the biologic width, allowing the crown to be placed on healthy tooth structure with a predictable long-term result.
They share the element of gum tissue removal but serve different purposes. Crown lengthening involves bone recontouring in addition to soft tissue removal — it is a periodontal surgical procedure for functional or restorative access. Gum contouring (gingivectomy) removes only soft tissue, typically for aesthetic purposes. The distinction depends on whether bone modification is needed.
Thirty to sixty minutes depending on the number of teeth treated and whether bone recontouring is needed on one or both sides of the tooth. The procedure is performed under local anesthesia with sedation available for patients who prefer it. Recovery at the office after the procedure takes 15 to 30 minutes.
Four to six weeks is the standard healing period before the restorative dentist takes the final impression for the crown. This allows the gum tissue to stabilize at its new position and ensures the crown margin can be placed accurately. Rushing the crown placement before healing is complete risks margin inaccuracy and tissue complications.
The procedure is performed under local anesthesia and is painless during surgery. Post-operative discomfort is moderate — soreness, minor swelling, and sensitivity at the surgical site for three to five days. Prescribed analgesics and soft foods manage recovery symptoms. Most patients report that the discomfort is less than they anticipated.
In many cases, yes. Teeth with subgingival fractures, deep decay, or insufficient clinical crown height that would otherwise be extracted can be preserved if crown lengthening provides adequate access for a restoration. The decision depends on the remaining tooth structure, root integrity, and overall strategic value of the tooth within the dental arch.
Most dental plans cover functional crown lengthening (performed to make a tooth restorable) as a periodontal surgical procedure. Aesthetic crown lengthening (for gummy smile correction) may be considered cosmetic and not covered. The front desk verifies your specific benefits and provides a cost estimate based on the clinical indication.
Risks include post-operative infection (rare with proper technique and oral hygiene), increased cold sensitivity due to root surface exposure, and potential aesthetic impact (the treated tooth may appear longer than its neighbors). Careful surgical planning minimizes these risks. The clinician discusses expected outcomes, including any anticipated aesthetic changes, before the procedure.
Multiple adjacent teeth can be treated in one session. Aesthetic crown lengthening for a gummy smile often involves four to eight upper front teeth. Functional crown lengthening is typically performed on one to two teeth at a time. The scope depends on the clinical need and the patient's tolerance.
Yes — intentionally. Functional crown lengthening makes the tooth appear slightly longer because more tooth structure is exposed. Aesthetic crown lengthening for a gummy smile transforms the smile by revealing more of the natural tooth crown. The new tooth-to-gum proportion is planned before surgery to achieve a balanced, natural-looking result.
Yes. Crown lengthening is frequently combined with extraction of adjacent hopeless teeth, bone grafting, or placement of a temporary crown. At ADSC, the multi-disciplinary setting allows the periodontal and restorative phases to be coordinated efficiently, often reducing the total number of appointments.
Do not brush the surgical area for two weeks — use the prescribed chlorhexidine rinse instead. Eat soft foods for the first week. Apply ice packs in 15-minute intervals for the first 24 hours to reduce swelling. Avoid smoking, which significantly impairs healing. Sutures are typically removed at one to two weeks.
Yes. Local anesthesia is standard. Nitrous oxide provides additional relaxation for mildly anxious patients. IV sedation is available for patients who prefer to have no awareness of the procedure. The sedation choice is discussed during the treatment planning visit and selected based on the patient's comfort level and the anticipated procedure duration.
Crown lengthening has a very high success rate when performed on teeth with adequate root length and bone support. The procedure itself is predictable — the outcomes that determine long-term success are the quality of the subsequent restoration and the patient's ongoing periodontal maintenance. Teeth restored after crown lengthening function normally for decades with proper care.
While some general dentists perform soft tissue crown lengthening, osseous (bone) crown lengthening is a periodontal surgical procedure that requires training in flap design, bone recontouring, and biologic width management. Advanced training ensures the surgery creates the precise tissue architecture needed for long-term restorative success without compromising adjacent teeth.