The OPTISMILE Podcast 98 - Crown Lengthening – Fixing the Gummy Smile

In this episode of Save Your Money, Save Your Teeth, Eon Engelbrecht speaks with Dr Clifford Yudelman from OptiSmile about crown lengthening, a dental procedure used to correct gummy smiles and create healthier foundations for restorations such as crowns and veneers.Dr Yudelman explains the biological principles behind gum and bone positioning, when laser gum contouring is sufficient, and when surgical crown lengthening is required. The discussion also compares crown lengthening with alternatives such as Botox and modern biomimetic techniques.Key Takeaways• A gummy smile occurs when excessive gum tissue is visible when smiling, which can make teeth appear shorter than they actually are.• One common cause is altered passive eruption, where the gums remain positioned too far down on the tooth surface after the teeth erupt.• Crown lengthening exposes more of the natural tooth by reshaping gum tissue and sometimes adjusting the bone around the tooth.• The procedure is based on the biological principle known as biological width, the natural space between the gums, tooth structure, and bone.• Crown lengthening can improve both smile aesthetics and long term oral health, particularly when preparing teeth for crowns or veneers.• In mild cases dentists may perform laser gum contouring, which is precise and minimally invasive.• In more complex cases a periodontist may perform surgical crown lengthening that involves adjusting the bone around the tooth.• When properly planned and executed, crown lengthening results are typically stable and long lasting.Questions with Summary Answers1. What is a gummy smile?A gummy smile occurs when an excessive amount of gum tissue is visible when a person smiles. Instead of the teeth being the dominant feature of the smile, the gums become more prominent. This can be caused by gum positioning, tooth eruption patterns, lip movement, or jaw structure.2. What causes a gummy smile?One common cause is altered passive eruption, where the gums cover too much of the tooth surface after the teeth erupt. The teeth themselves are normal in size, but they appear shorter because part of the tooth remains hidden beneath the gum tissue.3. What is crown lengthening?Crown lengthening is a dental procedure that exposes more of the natural tooth by reshaping gum tissue and sometimes adjusting the bone around the tooth. This improves tooth proportions and creates a healthier environment for restorations such as crowns or veneers.4. Is crown lengthening a major surgery?Not always. Minor gum contouring can often be performed using a dental laser and is quick with minimal discomfort. True surgical crown lengthening involves lifting the gums and adjusting the bone level around the tooth, which requires a longer healing period.5. What is biological width?Biological width refers to the natural space between the gum attachment and the underlying bone around a tooth. Dentists must respect this space when placing crowns or restorations to prevent inflammation, bleeding, and long term gum problems.6. Can crown lengthening save a broken tooth?Yes. If a tooth breaks under the gum line, crown lengthening can expose enough tooth structure to support a crown. This may allow the tooth to be restored rather than extracted.7. How do dental lasers help in this procedure?Modern diode lasers allow dentists to precisely reshape gum tissue with minimal bleeding and faster healing. Laser gum contouring is commonly used for cosmetic gum adjustments to create more balanced gum lines.8. Does the bone grow back after crown lengthening?No. Once the bone has been reshaped and the gums heal, the new position is generally stable when the procedure is planned and performed correctly.9. How long must patients wait before getting veneers or crowns?If bone reshaping is involved, dentists typically wait six to twelve weeks before placing final restorations. This allows the gums to stabilise and ensures predictable cosmetic results.10. Is crown lengthening cosmetic or medical?It can be both. Crown lengthening can improve the appearance of a gummy smile, but it also allows restorations to be placed in a biologically healthy position that supports long term gum health.Frequently Asked QuestionsIs crown lengthening painful?Most patients experience very little discomfort. Minor laser gum contouring procedures are usually quick and minimally invasive. When surgical crown lengthening is required, local anaesthetic is used and recovery is typically manageable with mild post treatment care.Is crown lengthening permanent?Yes. Once the gum and bone levels have been properly adjusted and healed, the results are generally stable and long lasting. Unlike Botox treatments, crown lengthening addresses the underlying structural cause of a gummy smile.Can crown lengthening improve the appearance of my smile?Yes. By exposing more of the natural tooth structure and creating balanced gum levels, crown lengthening can significantly improve tooth proportions and overall smile aesthetics.Further Resources Learn More About the Treatments MentionedThe following OptiSmile resources directly relate to the procedures and concepts discussed in this episode:Crown Lengthening & Gummy Smile TreatmentLearn how excess gum tissue and bone levels affect tooth appearance and what treatment options exist:OptiSmile – Dental Problems & SolutionsCosmetic Dentistry & Aesthetic PlanningExplore how crown lengthening fits into broader cosmetic dentistry and smile balancing:Cosmetic Dentistry at OptiSmileDigital Smile Design (DSD)See how OptiSmile plans gum levels, tooth length, and final smile proportions digitally before treatment begins:Digital Smile Design (DSD)Explore All Relevant Dental SolutionsView the full range of restorative and aesthetic treatments referenced in this episode:OptiSmile Dental ServicesBook a ConsultationIf you feel your teeth look short, your gums show too much when you smile, or you’ve been told a tooth is “unrestorable,” a professional assessment may help clarify your options:OptiSmile – Book an AppointmentContact the Best dentist in Cape TownBook your next Dental Checkup with OptiSmileFollow OptiSmile on FacebookDisclaimer: The content provided in this podcast, "Save Your Money Save Your Teeth" on Medical Mondays, is for informational and educational purposes only. It is not intended to serve as dental or medical advice. The insights and opinions expressed by Dr. Clifford Yudelman and any guests are designed to foster a better understanding of dental health, preventive measures, and general well-being, but should not be interpreted as professional dental or medical recommendations. Dr. Clifford Yudelman does not diagnose, treat, or offer prevention strategies for any health conditions directly through this podcast. This platform is not a substitute for the personalized care and advice provided by a licensed dental or healthcare professional. We strongly encourage our listeners to consult with their own dental care providers to address individual dental health needs and concerns. The information shared here aims to empower listeners with knowledge about dental health but must not be used as a basis for making health-related decisions without professional guidance. Your dental care provider is the best source of advice about your dental and overall health. Please always seek the advice of your dentist or other qualified health professionals regarding any questions or concerns about your dental health.