Quick answer
Aesthetic crown lengthening reshapes the gum line — and sometimes the bone — to make teeth look longer and the smile more even. It typically treats four to six upper teeth and costs $2,000–$5,000. It works best when the teeth are short because of the gum and bone level, not because of a hypermobile lip.
At a glance
- Typical scope
- Four to six upper front teeth
- Planning range
- $2,000–$5,000
- Gum-only or bone
- Depends on how much enamel is covered
- Result visible
- Immediately, then settles over 2–3 months
Aesthetic crown lengthening is the same operation as functional crown lengthening, planned for a different goal. Instead of exposing one broken tooth so a crown can seal, it reshapes the gum line across the smile so the teeth look longer, more even and better proportioned.
It is one of the most effective procedures in cosmetic dentistry when the diagnosis is right — and one of the most disappointing when it is used for a problem it cannot solve.
What it changes
The visible length of a tooth is the distance from the gum line to the incisal edge. That distance is set by three things:
- Where the bone sits. If the bone is high, the gum sits high and covers more of the crown.
- How much gum covers the crown. Even with a normal bone level, excess gum can make the teeth look short.
- How much tooth exists. Wear, erosion and old restorations can shorten the crown from the other direction.
Aesthetic crown lengthening changes the first two. It does not add tooth structure. If the teeth are short because they are worn, the solution is usually restoration — composite, veneers or crowns — not gum surgery.
The classic candidate has altered passive eruption: the gum did not recede to its normal position as the tooth erupted, so the clinical crown is short even though the tooth is a normal length. The gum looks thick and the teeth look square. Removing the excess gum — and, in many cases, a small amount of bone — reveals the tooth that was already there.
Who is a good candidate
A good candidate usually has:
- Short-looking upper front teeth with a low gum line.
- A gum line that is uneven from tooth to tooth.
- Healthy gums and healthy bone support.
- Teeth that are not severely worn or discoloured.
- A smile that shows the gum line when smiling.
- Realistic expectations about a surgical procedure and a healing period.
A poor candidate has:
- A gummy smile caused mainly by a hypermobile upper lip that pulls high when smiling.
- Vertical excess of the upper jaw, where the whole midface is long.
- Very short teeth because of wear, erosion or old restorations.
- Untreated periodontal disease or poor oral hygiene.
- A medical condition or medication that affects healing.
The distinction matters because the wrong procedure is expensive and irreversible. A periodontist should examine the lip, the jaw and the tooth proportions, not just the gum.
The planning stage
Aesthetic cases are planned before they are cut. The periodontist and restoring dentist usually:
- Photograph the smile at rest and in full smile.
- Measure the width-to-length ratio of the central incisors and the amount of gum shown.
- Use a digital mock-up or a wax-up to test the proposed tooth proportions.
- Measure the bone level to decide whether bone must be removed.
- Mark the new gum line on the teeth or a guide.
The goal is a gum line that follows the upper lip and sits at a natural height, with the central incisors slightly longer than the laterals and the gum line rising gently toward the back. Perfect symmetry is not the target; a believable smile is.
Gum only or gum and bone?
If the bone is already at the correct level and only excess gum covers the crown, a gingivectomy or laser contouring is enough. It is faster, cheaper and heals quickly.
If the bone sits high and the tooth is covered by both gum and bone, removing gum alone will not hold. The gum tends to grow back to its original level. In that case the periodontist raises a flap and recontours the bone, then positions the gum at the new line. This is the version that produces a stable result in a true altered-passive-eruption case.
The difference is why two quotes for “gum contouring” can be hundreds or thousands of dollars apart. Ask which procedure is planned and why.
What the appointment is like
The surgery usually covers four to six upper teeth, sometimes eight to ten for a full smile. It takes one to three hours depending on the scope. Local anaesthesia is standard; sedation is optional.
Afterwards, expect swelling for a few days, sore gums and a gum line that looks raw and uneven at first. Sutures come out at 7 to 14 days. The gum surface closes within two weeks, and the final contour settles over two to three months.
You may not need crowns or veneers at all. Many aesthetic crown lengthening patients keep their natural teeth and simply have a better gum line. If the teeth are also worn or discoloured, the restorative work is planned after the gum has stabilized.
What it costs
The 2026 planning range for aesthetic crown lengthening across four to six upper teeth is $2,000 to $5,000. The range reflects the number of teeth, whether bone is recontoured, the city and the complexity of the smile planning.
That fee does not include:
- Consultation and imaging ($100–$300).
- Sedation ($150–$800).
- Any veneers, crowns or composite bonding done afterwards.
- A retainer or night guard if clenching is a factor.
Insurance usually treats the procedure as cosmetic and pays nothing. If there is a restorative reason for part of the surgery, that portion may be documented separately, but the aesthetic portion is normally the patient’s cost. See the insurance guide for how plans draw the line.
The limits, stated plainly
Aesthetic crown lengthening cannot:
- Make a thin lip cover more gum.
- Stop the upper lip from rising too high when you smile.
- Shorten a long upper jaw.
- Add tooth structure that has been worn away.
- Guarantee a perfectly even gum line; minor asymmetry can persist.
- Be reversed. Bone removed does not grow back.
If your main concern is that your smile shows a lot of gum when you laugh, and your teeth are already a good length, the procedure may not be the answer. A consultation should include an honest discussion of what surgery can and cannot change.
Questions to ask
- What is causing the short appearance — gum, bone, tooth wear or lip position?
- Is this gum-only or gum and bone?
- How many teeth will be treated?
- Can I see a mock-up of the planned proportions?
- How much tooth will be exposed, and is that amount stable?
- What will the gum line look like at three months?
- What is the total cost, including any restoration afterwards?
The gummy smile guide goes deeper into diagnosis, and the short teeth guide covers the wear case.
Aesthetic crown lengthening vs veneers
| Aspect | Crown lengthening | Veneers |
|---|---|---|
| What changes | Gum and bone level around the teeth | The visible surface of the teeth |
| Tooth structure | Natural teeth are kept | Enamel is reduced for the veneers |
| Best for | Short teeth caused by excess gum or high bone | Worn, discoloured or chipped teeth with a good gum line |
| Typical cost | $2,000–$5,000 for the surgical case | Often $800–$2,500 per tooth |
Frequently asked questions
What is aesthetic crown lengthening?
It is crown lengthening planned around the smile rather than around a single restoration. The periodontist reshapes the gum line, and sometimes the bone, so the upper teeth look longer and more even. It is usually done across four to six front teeth.
Will my teeth look longer immediately?
Yes. The exposed tooth is visible as soon as the gum is repositioned. The gum line then settles over two to three months, and the final proportions are judged after the tissue matures. Some unevenness in the first weeks is normal.
Is aesthetic crown lengthening covered by insurance?
Usually not. Plans commonly classify purely aesthetic contouring as cosmetic and exclude it. If the procedure is documented as necessary for a restoration or periodontal health, part of it may be covered. Ask for a pre-treatment estimate before assuming either way.
Does it work for every gummy smile?
No. It works when the teeth are short because excess gum or a high bone level covers the crown. A smile dominated by a hypermobile upper lip, a short lip or vertical excess of the upper jaw needs a different assessment. Surgery on the gum alone will not change those.
Will there be a gap between my teeth afterwards?
Removing gum and bone can expose a space between the roots, especially if the teeth were close together. The periodontist plans the contour to preserve the papillae where possible. In some cases a small black triangle remains, and the restoring dentist may close it with a restoration.
How long before I can judge the final result?
The gum surface heals in one to two weeks, but the gum line continues to mature for about two to three months. Wait until then before judging the proportions or deciding whether a touch-up is needed. Photographs at the planning stage help compare the result.