1. Diagnosis. When a tooth is fractured or decay extends below the gum line, the bone and gum needs to be reduced in size around the teeth in order to get access to remove and restore the cavity, or to fix the tooth and place a filling or crown past the fracture. In order for the gum to heal against the tooth in a healthy manner, there must be sufficient space between healthy tooth structure and the crest of bone, which supports the tooth. This allows for proper attachment of the gum to the tooth.
2. Recommended Treatment. After an examination and study of my dental condition, my periodontist has advised me that I would benefit from a crown lengthening surgery. Local anesthetics will be administered as part of the surgery. In order to provide your dentist with better access and tooth structure to fix your tooth the gum and the bone will be reshaped and repositioned. The gum will then be sutured back closer to the new bone level, and a periodontal dressing/packing may be placed. As expected, the surgery will make it look like the gum receded, making the teeth look longer. You may also notice open spaces between your teeth after the procedure.
3. Expected Benefits. The purpose of the crown lengthening surgery is to give access for my dentist to correctly restore the tooth or teeth. The surgery is intended to help me keep my tooth/teeth in the operated area.
4. Principal Risks and Complications. Some patients do not respond successfully to periodontal surgery. In addition, other things in the future, such as accidents, root canal problems, tooth decay, periodontal disease, etc. could also cause the loss of the tooth/teeth we are trying to treat with crown lengthening surgery. I understand that complications may result from the crown lengthening surgery and drugs or anesthetics administered. These complications include, but are not limited to:
A. Post-‐surgical infection, bleeding, swelling, pain, facial discoloration (bruising). Local anesthetic injection may cause allergic reaction, temporary or permanent injury to nerves and/or blood vessels.
B. During surgery it may be impossible to avoid touching, moving, stretching, or injuring the nerves in my jaw that control sensations and function. This can lead to transient (usually this disappears slowly over several weeks or months) but on occasion permanent numbness, itching, burning, pain or tingling of the jaw, teeth, gums, tongue (including the possibility of loss of taste sensation), lip, chin, cheek, or in areas of the skin of the face.
C. Fracture of the jaws, fracture of the tooth/teeth during surgery. Loss or injury to adjacent teeth and soft tissue, loss or loosening of dental restorations, swallowing of a tooth or fragments of a tooth, accidental swallowing/aspiration of teeth, restorations and instruments.
D. Jaw joint injuries, pain or muscle spasm/stiffness cracking or bruising of the corners of the mouth, restricted ability to open the mouth for several days or weeks, impact on speech, and transient (on rare occasion permanent) increased tooth looseness, tooth sensitivity to hot, cold, sweet, or acidic foods or shrinkage of the gum upon healing. The exact duration of any complication cannot be determined, and they may be irreversible.
5. Alternatives to Suggested Treatment. Alternatives to crown lengthening surgery include: