Quick answer
A gingivectomy removes gum tissue only. Crown lengthening can remove gum and reshape bone, which is needed when the tooth is short because of the bone level. A gingivectomy costs $350–$900 per tooth; crown lengthening with bone runs $700–$1,800. The diagnosis decides which one is right.
At a glance
- Gingivectomy
- Soft tissue only; no bone removed
- Crown lengthening
- Gum, and usually some bone, recontoured
- Gingivectomy cost
- $350–$900 per tooth
- Crown lengthening cost
- $700–$1,800 per tooth
The two terms are used interchangeably in a lot of dental marketing, and that causes real confusion when quotes differ by a thousand dollars. They are not the same procedure, and the difference is not cosmetic — it is anatomical.
The one-sentence distinction
A gingivectomy removes gum tissue. Crown lengthening removes or repositions gum and, when needed, reshapes the bone underneath.
A gingivectomy can be a form of crown lengthening when the bone is already in the right place. But if the bone is high, a gingivectomy alone does not create a stable result.
What a gingivectomy does
The surgeon marks the new gum line, removes the excess strip of gum and places a dressing. There is no flap, no bone removal and often no sutures. The procedure is quick — 20 to 45 minutes for a quadrant — and recovery is comparatively easy.
It works best when:
- The teeth are short because of excess gum, not because of the bone.
- The bone level is normal or already reduced.
- The gum is thick and healthy.
- The goal is to even a slightly uneven gum line.
It works poorly when the bone sits high. The gum will try to return to its original thickness and position, and the tooth may look short again within months.
What crown lengthening adds
When bone is part of the problem, the surgeon raises a flap, reduces the bone around the root to the planned level, positions the gum lower and sutures it. The bone removal is what creates lasting space for the gum to sit at the new level.
This is the procedure required when:
- A crown margin would sit within about 2 mm of the bone.
- The tooth is short because the bone itself sits high.
- A fracture or cavity extends below the gum.
- The gum line has to be moved substantially to match the smile.
The trade-off is a longer appointment, a longer recovery and a higher fee.
Cost comparison
| Procedure | One tooth | Four to six teeth |
|---|---|---|
| Gingivectomy | $350 – $900 | $1,200 – $3,000 |
| Crown lengthening, gum and bone | $700 – $1,800 | $2,000 – $5,000 |
These are 2026 US cash-pay planning ranges for the surgical fee. They exclude consultation, imaging, sedation and any restoration. The gap is not arbitrary: the bone case takes more time, more skill and more follow-up.
Healing comparison
Gingivectomy: the gum surface closes in about one to two weeks. Discomfort is usually mild, and many patients return to normal eating within a few days. The gum line is largely stable by four to eight weeks.
Crown lengthening with bone: the surface also closes in one to two weeks, but the deeper tissue remodels for longer. Sutures come out at 7 to 14 days, and the gum line is judged at two to three months. Sensitivity and swelling are more pronounced.
Neither procedure is painless afterwards, but the bone case is a bigger recovery. Plan for it.
The diagnosis is the whole argument
A periodontist decides between the two by measuring, not by looking. The key measurements are:
- The bone level relative to the planned crown margin.
- The amount of attached gum around the tooth.
- The width of the tissue (thin versus thick biotype).
- The position of the tooth in the arch and the smile line.
If the bone is at the right level, a gingivectomy is the conservative choice. If the bone is high, a gingivectomy is a temporary fix. The what is crown lengthening guide explains the 3 mm rule that drives the decision.
Can you have both?
Yes. Some cases combine a gingivectomy on the teeth that need only soft-tissue correction with a flap and bone recontour on the teeth that need more. Aesthetic cases often blend the two across the arch so the gum line is even.
The quote should say which teeth get which procedure. A single “gum contouring” line for eight teeth is not enough information to compare.
What to ask
- Is the bone level high, normal or already reduced?
- Which teeth need gum only, and which need bone?
- What happens if we do only the gingivectomy?
- How much gum rebound should I expect?
- Is the fee per tooth or per quadrant?
- What is the total plan, including the crown or veneers?
If the answer to the third question is “it might grow back”, the cheaper procedure is not the cheaper plan.
The short version
Choose a gingivectomy when the gum is the only problem. Choose crown lengthening when the bone is part of the problem. The price difference reflects the surgery, not the marketing. And if a quote is unusually low for a case that involves bone, ask which procedure is actually being proposed.
Crown lengthening vs gingivectomy
| Aspect | Gingivectomy | Crown lengthening |
|---|---|---|
| Tissue treated | Gum only | Gum and bone |
| Flap needed | No | Yes, for the bone phase |
| Typical fee, one tooth | $350–$900 | $700–$1,800 |
| Sutures | Often none | Yes, 7–14 days |
| Gum rebound risk | Higher if bone is high | Lower when the bone is correctly reduced |
| Best for | Excess gum with a normal bone level | Short crown caused by the bone level |
Frequently asked questions
Is a gingivectomy the same as crown lengthening?
No, though the terms are often used loosely. A gingivectomy removes gum tissue only. Crown lengthening is the broader procedure that can remove gum and reshape bone. Some clinicians call a gum-only crown lengthening a gingivectomy, which adds to the confusion.
Which is cheaper?
Gingivectomy is cheaper because it is a shorter, simpler procedure with no bone work. The planning range is $350–$900 for one tooth, against $700–$1,800 for crown lengthening with bone recontouring. A cheap gingivectomy that does not solve the problem is not a saving.
How do I know which one I need?
The bone level decides. If the bone is at the correct height and only excess gum covers the tooth, a gingivectomy can be enough. If the bone sits high and the crown margin would be too close to it, bone has to be reduced. A periodontist measures this with a probe and radiographs.
Does a gingivectomy last?
It lasts when the bone level supports the new gum line. If the bone is high, the gum tends to return toward its original position, and the tooth looks short again. That rebound is the main reason a gum-only procedure fails in a bone case.
Which heals faster?
Gingivectomy usually heals faster. The surface closes in about one to two weeks, and there is no flap to stabilize. Crown lengthening with bone takes the same time for the surface but several more weeks for the gum line to mature, commonly two to three months.
Can a laser do a gingivectomy?
Yes. A soft-tissue laser can remove gum with less bleeding and good precision. It cannot remove bone, so it is a gingivectomy technique, not a substitute for osseous crown lengthening. The [laser guide](/guides/laser-crown-lengthening/) explains the limits.