Crown Lengthening

A quick overview of crown lengthening. Once the Decay is acessable, a permanent crown or filling can be placed. 

Crown lengthening is a dental procedure most often performed by a periodontist where an incremental amount of bone and tissue is removed from a tooth's gum line. This is most commonly used to reveal more tooth structure and facilitate the placement of a crown. If a tooth has deep decay or a fracture to the bone level, creating a good seal between tooth and crown is impossible. In order to save the tooth, the "crown" (portion of tooth above the gum line) has to be "lengthened," at the expense of the root. Crown lengthening is also performed on the anterior teeth for esthetic reasons. Uneven gum lines and "gummy" smiles can sometimes be fixed through this procedure. Many times, this must be followed up with crowns or veneers to create a cosmetic appearance. 

While crown lengthening allows us to save teeth that would otherwise need to be extracted, it is not without potential drawbacks. Lowering the gum and bone level on a tooth can compromise its long term stability in the jaw. By gaining length in the tooth crown, the roots become gradually shorter and less anchored in bone. This procedure can also negatively affect the adjacent teeth as well. The periodontist needs to create a natural bone contour, and will often need to adjust around the neighboring teeth to make a smooth transition. 

Often times, crown lengthening is only one of a few treatment options. Teeth can also be extruded using orthodontics to create more crown structure. Likewise, a tooth with a questionable longevity can be replaced with a implant in many scenarios. Only a comprehensive dental exam will reveal what can and needs to be done to save a tooth. To schedule an exam or find out about more dental treatment options, please give our office a call!

Video Blog on Periodontal Services

Greetings, my name is Dr. Kari Ann Hong, and I have a family dentistry practice, where I see patients from all age groups.  Approximately ⅓ to ½ of the population at large is affected by periodontal disease.  Periodontal disease is when the bacteria in the mouth causes loss of the bone surrounding the teeth.  From a patient’s perspective, gum disease can be characterized by bleeding gums, loose teeth, bad breath, and a feeling of deposits stuck to the teeth.

As a dentist, I determine if someone has periodontal disease by a combination of evaluating the bone levels and build up on a dental x-ray, measuring the gum health with something called periodontal probing depths, and by a visual inspection of the quality of the gum tissue.  Periodontal probing depths are a measurement of the height of the gum tissue to where the tissue is attaching to the tooth.  In health these measurements are 1-3mm.  Periodontal disease is diagnosed as mild, moderate, or severe and this is primarily based on the amount of bone loss present.

I diagnose a service called scaling and root planing when the probing depths are 4mm or more, the gum tissue bleeds when touched, bone loss is present, and there is tartar build up under the gum tissue.  Scaling and root planing is done with local anesthesia and is usually billed by quadrant and/or the number of appointments required to adequately remove all of the build up. In severe cases, scaling and root planing can take as many as four separate appointments.  

There are some practices that will recommend procedures called irrigation,  localized antibiotic placement (Arrestin), or laser treatment to help with the treatment of periodontal disease.  Irrigation involves squirting an antibacterial prescription mouth wash called Chlorhexidine or Peridex around the teeth.  Arrestin is an antibiotic called doxycline that is injected directly into the deeper pocket depth areas.  Laser treatment involves shining a specific wavelength of light in the pocket area to kill the bacteria.  In my opinion, the irrigation and Arrestin treatment are helpful at the time of treatment, but do not have enough long term benefits to justify doing the procedure.  Laser treatment is an effective way at killing bacteria and has longer acting benefits than the irrigation and Arrestin, but is not a cure all for periodontal disease.  Those with periodontal disease need to adhere to a consistent professional periodontal maintenance routine in order to maintain their dental health.

If you are interested in periodontal services, please fill out the contact us information at the bottom of this page.

Specialist Spotlight- Periodontist Dr. Jeremy Wilgus

At Thousand Oaks Family Dentistry, we are proud of the incredible patient centric experience we have built at our practice. At the end of every day, our goal is to see every person leave happier, healthier and more satisfied with their oral health.  However, this experience does not stop once you walk out our front door. A major component of our unique patient care is the incredible network of dedicated and skilled specialists we work with.

One of these great specialists is periodontist Dr. Jeremy Wilgus at Camarillo Periodontics. As a periodontist, Dr. Wilgus’ emphasis within dentistry is the treatment of periodontal disease, gingival recession and replacement of missing teeth with dental implants. Gingival grafting, crown lengthening, implant placement and bone grafts all fall under his scope of dental treatment.

At his office, Dr. Wilgus offers a combination of state-of-the-art technology and compassionate treatment. We are always impressed with the clinical results of his work, while our patients have nothing but great things to say about him and his office staff. Among the modern techniques he provides is the use of a Cone Beam CT scanner. This device allows him to capture a true 3D image of your jaw to aid in implant placement, diagnostics and other sensitive situations. This technology proves to be more accurate and revealing than the two dimensional nature of traditional dental X-rays.

Dr. Wilgus grew up in Sacramento, Ca and received his DDS from UCSF in 2003. He went on to finish a periodontal residency at the Los Angeles VA in 2006. In his off time, he enjoys spending time with his wife and two sons. You can typically find him cycling, golfing, skiing or coaching his son’s sports teams.

Whether you need a gingival graft, crown lengthening, or a complex bone graft you will be in good hands with Dr. Wilgus. Our office is extremely selective with our referral network and are proud to extend his services to our patients. If you are curious about periodontics or want to know more about our specialist referral network, feel free to call our office!

Additionally, make sure to check out Dr. Wilgus' office website at http://www.camarilloperio.com/