Cost hub
Crown lengthening cost
What the surgery costs per tooth and per smile, why a bone case costs more than a gum-only reshape, and the questions that turn a range into a real quote.
Edited by Maya Ellison, Health Editor · Planning ranges, not dental advice.
The number to start with
$700–$1,800 for one tooth with gum and bone recontouring. $350–$900 for a gum-only reshape. $2,000–$5,000 for aesthetic crown lengthening across four to six upper teeth. These are 2026 US cash-pay planning ranges; the surgical fee never includes the final crown.
Cost by situation
A quote is built from the number of teeth, the tissue involved and the setting. Find the row that matches your case, then treat the range as a budget line rather than a price.
| Situation | Planning range | What it covers |
|---|---|---|
| One tooth, gum and bone | $700 – $1,800 | Flap raised, a small amount of bone recontoured, gum sutured lower. The standard functional case before a crown. |
| One tooth, gum only | $350 – $900 | Gingivectomy or laser contouring when the bone level is already correct and only excess gum covers the tooth. |
| Two to three adjacent teeth | $1,400 – $3,600 | Often quoted as one surgical site. Additional teeth usually cost less than the first, but the gum line has to be blended across the group. |
| Aesthetic, four to six upper teeth | $2,000 – $5,000 | Smile-line planning, a longer surgical field and sometimes a temporary restoration while the gum matures. |
| Laser gum contouring | $400 – $1,200 | Soft tissue only. Appropriate for uneven gum heights when the bone does not need to move. It is not a substitute for osseous surgery. |
| With extraction or bone graft | $900 – $2,600 | A combined site: the tooth is removed, the socket is grafted, or both. The graft and membrane are billed separately. |
Planning ranges for the surgical fee only. Fees vary with the city, the clinician, the tooth and whether sedation is added. They are not quotes and they are not a price index for any state.
What the surgical fee usually includes
- The surgical fee for the treated teeth
- Local anaesthesia
- Sutures and the post-operative instructions
- A routine suture-removal visit at 7–14 days
What is usually billed separately
- Consultation and imaging (often $100–$300; sometimes credited)
- Oral or IV sedation ($150–$800 depending on type)
- A temporary crown or provisional restoration
- Bone graft or membrane at a combined site ($400–$1,200)
- A night guard if clenching is a factor
- A final crown — the restoration is always separate
The rest of the budget
Crown lengthening is stage one of a two-stage plan when a tooth needs a crown. The restoration is a separate fee from the restoring dentist, and the temporary crown may be charged on the day of preparation.
The crown range is a general dental restoration range, not a periodontal fee. Material, tooth position and lab work move it.
Why a gum-only quote can be a third of a bone case
A gingivectomy removes a strip of gum. The surgeon marks the new gum line, removes the excess tissue and places a surgical dressing. There is no flap, no bone removal and no need to suture the gum into a new position. Healing is comparatively quick, and the fee reflects a shorter, simpler procedure.
Crown lengthening with bone recontouring is a different operation. The gum is raised as a flap, the bone around the tooth is reduced to expose more root, the flap is positioned lower and sutured, and the site is reviewed while the attachment re-forms. The procedure takes longer, requires more surgical skill and has a longer recovery. That is what the extra fee buys.
The distinction matters when you compare quotes. A $450 quote may be a gingivectomy for a case that needed bone removed; a $1,600 quote may be the correct operation. Ask which procedure is being proposed and why, not just which number is lower.
Gum-only vs gum and bone
| Aspect | Gum only | Gum + bone |
|---|---|---|
| Typical fee | $350–$900 | $700–$1,800 |
| Flap | No | Yes |
| Bone removed | No | Usually a small amount |
| Sutures | Sometimes none | Yes, 7–14 days |
| Best for | Excess gum, normal bone | Short crown, deep margin |
A periodontist measures the available tooth and the bone level before choosing. The fee follows the procedure, not the other way round.
Does insurance cover crown lengthening?
The answer depends on why the procedure is being done. A plan is more likely to contribute when crown lengthening is necessary to restore a fractured tooth, to treat a periodontal defect or to place a crown that would otherwise sit on unsound tooth. It is less likely to pay for contouring done only to change the appearance of a smile.
When a plan does cover it, the benefit is usually a percentage of the allowed fee — commonly 50% to 80% — after a deductible, and it counts toward an annual maximum that is often $1,000 to $2,000. That maximum can be consumed by the crown lengthening alone, leaving the final crown to be paid out of pocket.
The practical step is a pre-treatment estimate. Give the office your plan details and ask them to submit the proposed procedure and CDT code before surgery. The written response tells you what the plan will pay, what it will not, and which documentation it wants.
CDT codes you may see
These are the codes a periodontal office is likely to use. The code should match the procedure described in the quote.
- D4249 — clinical crown lengthening, hard tissue
- D4210 — gingivectomy/gingivoplasty, four or more teeth per quadrant
- D4211 — gingivectomy/gingivoplasty, one to three teeth per quadrant
- D4260 — osseous surgery, four or more teeth per quadrant
- D4261 — osseous surgery, one to three teeth per quadrant
A quote that names only a code and a total is incomplete. Ask for the tooth numbers and the procedure in plain language too.
Eight questions that turn a range into a quote
Ask these at the consultation and write the answers down. A practice that will not put the fee and the procedure in writing is not a practice to prepay.
- Which teeth are being treated, and is the fee per tooth or per surgical site?
- Is bone being recontoured, or is this gum-only?
- What CDT code will appear on the claim?
- Is the consultation, imaging and suture removal included?
- Is sedation included, and who administers it?
- Does the fee include a temporary crown if the tooth is prepared?
- What happens if the gum rebounds and a second procedure is needed?
- Which insurance plans is the office in network with?
What actually moves the price
How many teeth
One tooth is a small surgical site. Aesthetic crown lengthening usually covers four to six upper teeth so the gum line stays even; the fee rises with each additional tooth and with the need to blend the result into the smile.
Gum only or gum and bone
Removing gum is faster and cheaper than recontouring bone. Functional crown lengthening often needs bone removed so the crown has at least 3 mm of sound tooth to seal against; that converts a gingivectomy into a flap and osseous surgery.
Who performs it
A periodontist's surgical fee is usually higher than a general dentist's for the same procedure, but the procedure is core periodontal training. Complex cases, cosmetic cases and re-treatment are usually referred.
Where you live
Metro practices in high-rent markets charge more than small-city practices. The directory lists practices by city so you can collect two or three local quotes instead of relying on a national average.
Sedation and add-ons
Local anaesthesia is included. Oral or IV sedation, a surgical guide, a temporary crown, a bone graft or a frenectomy are billed separately and can add several hundred dollars.
Insurance status
Crown lengthening is often classified as restorative or periodontal rather than cosmetic. That distinction decides whether a plan pays anything at all; see the insurance guide for the questions to ask.
Get local quotes. National ranges tell you what to expect, not what your periodontist charges. Browse the periodontist directory, pick two or three practices and ask each for the same written breakdown.
Crown lengthening cost questions
How much does crown lengthening cost per tooth?
For one tooth with gum and bone recontouring, most US cash-pay quotes fall between $700 and $1,800. A gum-only gingivectomy is typically $350 to $900. The upper end covers molar sites, bone removal, a periodontist's surgical fee and metro markets.
Is crown lengthening covered by dental insurance?
It can be, when the procedure is documented as necessary for a restoration or for periodontal health. Plans commonly pay 50% to 80% of the allowed fee after a deductible, up to an annual maximum. Purely aesthetic contouring is usually excluded. Send the office your plan details and ask for a pre-treatment estimate.
Why is crown lengthening more expensive than a gingivectomy?
A gingivectomy removes gum tissue. Crown lengthening that involves bone requires a flap, bone recontouring, careful closure and a longer healing period. The additional surgical time, skill and follow-up are what raise the fee — not the name of the procedure.
Does the cost include the crown?
No. Crown lengthening is a separate surgical procedure. The final crown, a temporary crown and any build-up are billed by the restoring dentist. Budget for both stages; the crown commonly costs $1,000 to $2,000 or more depending on the material and the tooth.
Can I get crown lengthening on a payment plan?
Many periodontal offices offer in-house instalments or third-party financing. Ask before the consultation, and compare the total cost of the plan with the interest-free period. A payment plan changes the timing, not the fee.
Is a cheaper gum-only procedure enough?
Only if the bone level already allows enough tooth for the restoration. If a crown margin would sit too close to the bone, removing gum alone leaves the same problem and the gum may grow back. A periodontist can measure the available tooth and explain which procedure your case needs.
Cost figures are planning ranges compiled from publicly reported US fee ranges, not quotes. Read the editorial policy for how they are built and updated.