Crown Lengthening

Crown lengthening is a procedure to remove the excess gum tissue, exposing more of the “crown” of the tooth. The gum line is then sculpted (or sutured) to create the right proportion between gum tissue and tooth surface. This sets the stage, allowing your new veneers or crowns to have the correct length and shape.

Reasons for Crown Lengthening
This procedure is for patients who feel their teeth are too short (known as a gummy smile) or their gum line is uneven.

Gummy Smile

13-year-old girl with brown hair and a gummy smileA 13-year-old girl has excessive gingival over­growth (a gummy smile) due to orthodontics.

girl with brown hair with blonde highlights with a beautiful smileEighteen months after crown lengthening procedure.

girl with blonde hair and brown roots posing and smiling beautifullyFour years after crown lengthening procedure.


smile showing an unaesthetic dental crownA patient wanted to improve the appearance of her crown to enhance her smile prior to her wedding.

smile after the bone support was reshapedA minimally invasive, micro­-surgical technique was used to reshape the bone support and to achieve symmetrical crown lengths.

smile improved by crown lengthening and a new dental crownResults after crown lengthening and a new crown.


smile showing teeth that slant to the rightAfter orthodontic treatment, the patient’s teeth appear to slope down to the right and her lower lip appears asymmetrical.

smile showing improved tooth length and symmetry after treatmentTwo months after treatment, tooth length and symmetry are improved.

Root Coverage

During this procedure, gum tissue from your palate or other materials are used to facilitate coverage of the exposed root. This can be done for one tooth or several teeth to even your gum line and reduce sensitivity.

Reasons for Root Coverage
Soft tissue grafts can be used to cover roots, develop gum tissue where absent due to excessive gingival recession, or to make prosthetic devices, such as dental implants, look natural. In some cases, they can cover exposed roots to protect them from decay and prepare teeth for orthodontic treatment. This may reduce tooth sensitivity and improve the aesthetics of your smile as well.

oral cavity with exposed tooth roots on the bottom archRoot coverage will enhance this patient’s smile and thicken his gums, decreasing the risk of recession during orthodontic treatment.
Exposed Roots
oral cavity with exposed tooth roots on the upper archThis patient wanted to improve her smile.
Dental Implant
smile showing a partially exposed dental implant in the frontThis patient’s front dental implant was partially exposed, creating an undesirable smile.

oral cavity with metal braces and root exposure correctedRoot coverage was completed in one surgery with a gingival graft and the patient underwent orthodontic therapy three months later.

oral cavity showing corrected root exposureRoot coverage was achieved, as well as a significant thickening of the gums, which decreases her risk of obtaining periodontal diseases.

smile showing exposed implant corrected by a gum graftGingival graft was placed to cover the exposed implant so the restorations did not need to be replaced.

oral cavity showing the results of periodontal treatment and orthodontic therapyFinal results after periodontal treatment and orthodontic therapy.

Ridge Augmentation

Ridge augmentation procedures are used to correct concavities in the jawbone where natural teeth are missing.

Reasons for Ridge Augmentation
Ridge augmentation corrects depressions in your gum line that are unnatural looking and sometimes make you seem older than you really are. It is also used to prevent the jawbone from collapsing following tooth extraction and helps to even out replacement teeth that may seem too long compared to adjacent teeth.

Asymmetrical Bridge
a dental bridge in the mouth that has become asymmetricalThis patient had a fixed bridge and one of the teeth became asymmetri­cal due to a concavity of his jawbone.
Ridge Deficiency
oral cavity with gum deficiency and teeth with porcelain extensionsThis patient has a significant gum deficiency and the adjacent teeth have porcelain extensions to create symmetry with the abnormally long two front teeth.

Upper teeth after a connective tissue ridge augmentationA connective tissue ridge augmentation procedure was performed to repair the concavity.

Upper teeth with new bridge with completely revised teeth lengths after ridge augmentationA new bridge with completely revised teeth lengths after ridge augmentation created a much enhanced gum profile.

Upper teeth with fixed bridge after ridge augmentation to build up the jawboneRidge augmentation builds up the jawbone, giving the fixed bridge a more natural look.

Combination Procedures

A combination of periodontal procedures can result in a beautiful new smile and improved periodontal health – your keys to smiling, eating, and speaking with comfort and confidence.

Reasons for Combination Procedures
Your periodontist may use several different types of procedures to build a framework for your perfect smile. Oftentimes, periodontal plastic surgery lays the foundation for further cosmetic enhancements by your general dentist.

For more information on periodontal plastic cosmetic surgery and other types of gum surgery in Palm Desert, California, we welcome you to contact us today. Our skilled dentist, Dr. Anne Nicholas, and her team are ready to help you improve your smile!

(Root Coverage/Crown Lengthening)

Upper teeth with an uneven and receding gumline
Oral cavity with repaired upper gumline and veneers applied to teeth

This patient wanted an even gum line before getting veneers. The combination of procedures helped to achieve this goal.

Teeth straightened by orthodontics with a high gumline on two front teeth After orthodontic treatment, this patient wanted an even smile.

Girlish Smile

Woman with brown hair smiling and showing two front teeth with raised gums
Woman with brown hair smiling with straightened teeth and gums evened out

These full face before and after photos illustrate there are different tooth shapes and also different types of faces and smiles. A gingival graft and crown lengthening helped improve this young lady’s “girlish smile.”

Groundwork for a Perfect Smile

Mouth with decayed teeth and metal restorations on molars
Smile with white straight even teeth and metal restorations removed

After orthodontic treatment, this patient wanted an even smile.

Straight smile after orthodontics and root coverage procedureFinal results show the success of root coverage and crown lengthening procedures.

Before & After

Teeth with advanced gum recession and frenum pullAdvanced recession, sensitivity, and frenum pull create a micro-gingival problem.
Teeth after a connective gingival graft and frenectomyA connective gingival graft taken from the palate (plus frenectomy) solved the problem.
Upper teeth with gums receding far up the rootsAesthetics, sensitivity, and minimal keratinized gingiva.
Upper teeth with gums repaired from a graftA connective tissue graft solved this problem.
Teeth with gum recession caused by a badly fitted dentureSevere recession caused by an ill-fitting partial denture (RPD).
Teeth with one amalgam filling and repaired gums after a tissue graftA pedicle flap from the adjacent edentulous ridge solves this problem.
Excessively crowded teeth with overgrown gums caused by plaqueGingival overgrowth caused by an excessive amount of plaque (enhanced by tooth position/crowding).
[No medical problem/medication.]
Crowded teeth after gingivectomy and microdermabrasion to correct gumsGingivectomy followed by dermabrasion for ideal contour solves this problem, followed by orthodontic treatment to take care of the crowding.
Teeth with advanced gum disease at risk of losing a bridge made of goldFrenum pull and lack of keratinized gingiva create a micro-gingival problem that can cause loss of a five-unit bridge.
Gold tooth bridge saved after a tissue graft to the gumsA free-gingival graft solves this problem. No pocket present following treatment, saving the tooth and bridge.
Crowded bottom teeth with advanced gum recessionAdvanced gingival recession, minimal keratinized gingiva, and crowding.
Teeth ready for orthodontics after repairing gums with a tissue graftConnective tissue graft preceding the orthodontic treatment solves the problem.
Upper teeth showing different crown lengths Crown length discrepancy: the right central is too short, while the left lateral has receded.
Upper teeth after gum recontouring and root coverageCrown lengthening with osseous recontouring and root coverage.
Upper tooth with advanced gum recession Aesthetic problem due to advancing recession.
Upper tooth with repaired gums from tissue graft and new porcelain crownA connective tissue graft with a new crown solves this problem by creating a natural appearance.
Upper teeth with a receded papilla between the two front onesReceded papilla.
Upper teeth after a procedure to correct receded papillaA two-step surgical procedure can correct the defect, achieving harmonious anatomy.
Upper teeth with advanced gum recession leaving a gap between crowns and gumsRidge resorption.
Upper teeth after a soft-tissue ridge augmentation procedure to close a gap above crownsA soft-tissue ridge augmentation procedure solved the problem.
Set of teeth with one lower tooth that has a severe receding gumline
Lower teeth with one tooth that has a repaired gumline
Lower teeth with severely recessed and discolored gums


Upper teeth with advanced gum recession and discolored roots
Upper teeth after root covering to repair receding gums
Teeth with bottom row bleeding from severely recessed gums
Bottom teeth after recessed gums have been repaired
Upper teeth with ridge resorption after traumatic loss of one toothRidge resorption due to traumatic tooth loss prevents implant.
Upper teeth after plastic periodontal surgery to fix ridge resorbptionPlastic periodontal surgery can help.