Crown lengthening is typically the precursor to more to dental work that replaces lost crown structure of the tooth. When the crown of the tooth breaks because of loss of tooth structure due to decay or stress fracture or is undermind by root decay or other gum dental health issues space on the root need to be accessed to improve crown retention. The procedure involves removing gum and bone tissue in order to expose more of the tooth beneath the gum line. This prevents impingement of the crown margin on the bone and ligament attachment to the tooth.
The healing process following crown lengthening takes around two months in total and must be completed before the tooth or bridge abutment teeth are impressed and sent to the lab for fabrication of the crown or bridge. While the full process of healing and maturation takes several months, the first two to three days following the procedure require the most consideration on the part of the patient. In this immediate post-operative period, patients should give the gum tissue plenty of rest, and limit chewing and brushing at the site of the crown lengthening.
Anesthetics are used during the crown lengthening procedure to keep the patient from feeling anything in the area. Once the anesthesia wears off after surgery, there should be little or no discomfort due to the use of a special long-term anesthetic called Marcaine. Slight weakness or chills may also be felt. Patients are encouraged to take aspirin-free and nonsteroidal anti-inflammatory pain relievers to prevent any pain. It is important to time dosages properly and in accordance with printed guidelines in order to avoid unnecessary discomfort.
Swelling and Bleeding
Swelling and bleeding may occur during the first 24-48 hours following surgery with bone or gum grafting. To manage this swelling and bleeding, patients can apply a cool ice pack, cool, damp washcloth to the site of the surgery. This should be applied with gentle pressure in 20-minute cycles. It is preferrable to avoid hot food and beverages for the first 24 hours following surgery. Patients must also avoid vigorously rinsing their mouths during this initial day-long period. Ignoring these guidelines may cause bleeding to persist. What little bleeding does occur will mix with your saliva and is often misinterpreted to be more bleeding than is really happening.
For some patients, a surgical dressing is applied to the surgical site. The instructions detailed above for swelling and bleeding can be used here as well, with pressure applied over the dressing. The dressing may remain in place for 7-14 days, with the doctor replacing the dressing as needed during this period.
Teeth nearby the surgical site will often be sensitive to temperature extremes for a short period several weeks following the surgery. This should decrease gradually as the surgical site heals, with the crown, bridge, or implant providing further relief. In the meantime, it is important to avoid overly hot or cold food and beverages.
A diet of soft, easily chewable malleable, bland foods is advised for patients during the recovery period. Hard, brittle, sticky, spicy, and acidic foods should all be avoided, along with anything containing nuts or seeds. When chewing, it is advised that patients use the side of their mouth opposite the surgical site. Beyond these guidelines, patients are also advised to refrain from alcohol and smoking. Both alcohol and smoking can cause prolonged bleeding and slower healing.
Proper oral hygiene is imperative following a crown lengthening. Following meals and snacks, patients should clean their entire mouth. A soft bristle brush should be used, with patients being careful to avoid brushing the surgical site. An antiseptic mouthwash is typically recommended as well for use in the cleaning process. Flossing should also continue on unaffected teeth.
Follow-up visits and additional guidelines will be communicated to the patient at the time of surgery. For more information on crown lengthening, contact Specialty Dental Care P.C. here in Omaha, NE at 402.334.8083.