Crown Lengthening for Biologic Width Violations: Prevent Chronic Inflammation

Protect Your Smile From Hidden Gum Damage

A crown or filling can look beautiful and still cause trouble if it sits too close to your gums. Many people notice sore, puffy tissue around a new restoration and assume it is normal or that they just need to brush harder. When the real problem is a biologic width violation, no amount of extra brushing will fix it.

Biologic width is the natural protective space your gums and bone need around each tooth to stay healthy. When a crown, veneer, or filling invades that space, the gums stay inflamed, bleed easily, and may become sensitive. Crown lengthening is a precise periodontal procedure that restores this space so your gums can calm down and stay healthy around your dental work. 

Understanding Biologic Width and Why It Matters

Biologic width is the natural zone of tissue that attaches your gum and bone to your tooth. Think of it as a built-in safety border your body protects to keep bacteria away from deeper structures. Your body does not like anything invading that space, even a very well-made crown.

When a restoration is placed too close to or under the gum line, the body responds with ongoing irritation. Common signs include:

• Red, puffy gum tissue around one tooth  
• Bleeding when you brush or floss around that area  
• Tenderness, soreness, or a feeling that the gum is “angry”  
• Food catching at the edge of the crown or filling  

Over time, this constant irritation can lead to bone loss around the tooth. Even if the restoration fits nicely on the tooth itself, it can still fail if it violates the biologic width. Patients often end up with repeated gum treatments, bite adjustments, or crown replacements, while the true cause is the lack of proper space between the edge of the restoration and the bone.

How Biologic Width Violations Develop Around Restorations

Biologic width problems can start in several ways. Sometimes they come from trying to save teeth that have deep decay or fractures near the gum line. Other times, they are tied to old dental work that was done before current standards for gum and bone health were widely followed.

Common causes include:

• Deep decay or cavities that extend below the gum margin  
• Teeth that look short in the mouth, leaving little tooth above the gum for a crown  
• Fractured teeth near the gum line that need extra support  
• Older crowns or fillings with deep margins placed under the tissue  

If a crown margin is too tight against the gum, too bulky, or hangs over the natural tooth, it creates a trap for plaque and bacteria. This makes it hard to clean and keeps the area inflamed. Waiting to see if the gum will “settle down” usually does not work. Instead, the chronic irritation may lead to:

• Gum recession, where tissue pulls away from the tooth  
• Sensitivity along exposed root surfaces  
• Gradual bone loss that weakens support for the tooth  

Fixing the underlying biologic width violation is key if you want the gums to truly heal.

How Crown Lengthening Restores Healthy Gum Space

Crown lengthening is a periodontal procedure that reshapes gum tissue and sometimes a small amount of bone to expose more natural tooth structure above the gum line. The goal is not to make the tooth “long” just for looks. It is to create a healthy, stable zone that respects the biologic width and supports long-lasting dental work.

By adjusting the gum and bone levels, crown lengthening:

• Creates the proper distance between the bone and the edge of the future restoration  
• Removes inflamed tissue that is trapped around deep margins  
• Allows your general dentist to place a crown or filling where your gums can stay comfortable  

At Fort Collins Periodontics and Dental Implants, the crown lengthening process usually includes:

• A detailed exam of your gums and bite  
• Diagnostic X-rays or imaging to measure existing bone levels  
• Careful planning with your restoring dentist so the final crown fits the new gum contour  
• Precise reshaping of gum tissue and, when needed, contouring of the underlying bone  

This team approach helps protect both your gum health and your investment in restorative dentistry.

Clinical Benefits of Crown Lengthening for Restorations

When biologic width is respected, gums tend to feel better, look better, and stay healthier. Crown lengthening can offer several benefits around a problem crown or planned restoration.

Health benefits:

• Less bleeding and tenderness when brushing or flossing  
• A tighter, more stable gum attachment around the tooth  
• Reduced risk of ongoing bone loss around the root  
• Easier day-to-day cleaning for the patient  

Restorative advantages:

• More natural tooth exposed for stronger bonding of a crown or filling  
• Better fit and contour of the final restoration  
• Fewer deep edges that trap plaque and food  
• Improved chance that the restoration will last longer  

There are also important cosmetic gains, especially for front teeth:

• More even, symmetrical gum lines  
• Less puffy or rolled tissue around crowns  
• A smoother, more natural meeting line between tooth and restoration  

For patients who are planning veneers or crowns in the smile zone, crown lengthening can help create a balanced frame of gum tissue that supports a confident smile.

What to Expect Before, During, and After Treatment

Before treatment, we start with a periodontal evaluation and X-rays. We talk through your symptoms, such as bleeding around one tooth or a crown that has never felt “quite right.” Then we coordinate with your general dentist so everyone shares the same plan for the final restoration.

During crown lengthening, most patients are surprised by how manageable the procedure feels. It is typically done with local anesthesia to numb the area. For patients who feel nervous, we can discuss options to keep you more relaxed and comfortable. In many cases, the procedure is completed in a single visit, and you leave with instructions on how to care for the area while it heals.

Recovery is usually straightforward:

• Mild soreness for a few days that is often well controlled with recommended care  
• A softer diet at first so you do not bump the area while it heals  
• Gentle brushing and cleaning as directed to keep the site healthy  

Sutures are usually removed after a short healing period. Your gums will continue to mature and settle over several weeks. Once the tissue is stable, your general dentist can safely place or replace the final crown or restoration so it fits the new, healthier gum position.

Why Work With a Periodontal Specialist in Fort Collins

Biologic width cases require careful planning of both gum tissue and bone levels. A periodontist focuses on these supporting structures every day, which is why many dentists refer their patients for crown lengthening when there is a risk of biologic width problems.

A specialist can offer:

• Precise management of gum and bone to respect biologic width  
• Advanced imaging and tools for detailed planning  
• An understanding of how gums will heal and shape themselves around future crowns  

At Fort Collins Periodontics and Dental Implants, we work closely with general dentists and restorative teams across Northern Colorado. Together, we time the procedure and restoration so your gums can heal properly before final crowns are placed. Our goal is to keep your gums calm and comfortable around your dental work so your smile feels as good as it looks, season after season.

Take The Next Step Toward a Healthier, More Confident Smile

If you are considering crown lengthening to support a new restoration or improve your gumline, we are here to help you understand all your options. At Fort Collins Periodontics and Dental Implants, we will evaluate your needs, answer your questions, and create a personalized treatment plan. To schedule an appointment or ask about your specific situation, simply contact us and our team will be glad to assist you.