Crown lengthening typically costs between $800 and $3,000 per tooth, depending on whether the procedure involves gum tissue only or requires bone removal as well. The total you pay will vary based on the complexity of your case, how many teeth are involved, and whether your dental insurance covers any portion of the bill.
Cost Per Tooth: Gum-Only vs. Bone Removal
The single biggest factor in pricing is what your periodontist needs to do beneath the gumline. When only soft tissue needs to be reshaped, the cost generally falls between $800 and $2,000 per tooth. This version of the procedure is faster and less invasive, so it comes in at the lower end of the range.
When the surgeon also needs to reshape or remove bone to expose more of the tooth structure, the price climbs to roughly $2,000 to $3,000 per tooth. Bone work adds surgical time, requires more specialized instruments, and involves a longer healing period, all of which contribute to the higher cost. If multiple teeth need treatment in the same session, some practices offer a reduced per-tooth rate, but a multi-tooth case can still reach $4,000 or more.
Why the Procedure Costs What It Does
Crown lengthening is oral surgery, not a routine cleaning. The periodontist makes incisions in the gum tissue, lifts it away from the tooth, and repositions or removes tissue to expose more of the tooth’s surface. In more complex cases, they also contour the underlying bone to create enough clearance for a future crown or filling to attach properly. The procedure requires imaging, local anesthesia, sutures, and follow-up visits, all of which factor into the total bill.
Your periodontist chooses the technique based on how much tooth structure is hidden, how close the bone sits to the edge of the tooth, and whether there’s enough healthy gum tissue to work with. A case where the bone sits right at the junction between the tooth and root will almost always need bone recontouring, pushing costs toward the higher end.
Sedation and Additional Fees
Most crown lengthening is done under local anesthesia, which is typically included in the quoted price. If you want or need additional sedation, that cost is usually separate:
- Nitrous oxide (laughing gas): $75 to $150
- Oral sedation: $150 to $400
- IV sedation: $800 to $1,600
You should also factor in the cost of whatever restoration follows the surgery. Crown lengthening is rarely the final step. Most people need it so a dental crown, bridge, or large filling can be placed afterward. A standard dental crown runs anywhere from $800 to $1,700 depending on material, which means the full treatment sequence (surgery plus crown) can total $1,600 to $4,700 or more per tooth.
Does Insurance Cover Crown Lengthening?
Dental insurance sometimes covers crown lengthening, but only when it’s medically necessary. The key distinction is functional versus cosmetic. If the procedure is being done to fix a “gummy smile” or improve appearance, insurers classify it as cosmetic and won’t pay for it.
For coverage to kick in, there usually needs to be radiographic evidence that decay or a fracture extends below the gumline, making it impossible to place a restoration without surgically exposing more tooth. Aetna’s clinical policy, for example, specifically looks for fracture or decay that reaches near or below the bone level as the standard indication. If your case meets those criteria, insurance may cover a significant portion, though you’ll still face copays and deductibles. Ask your periodontist’s office to submit a pre-authorization so you know your out-of-pocket cost before scheduling.
Cosmetic Crown Lengthening Costs Less Per Tooth
Cosmetic gum contouring, sometimes called aesthetic crown lengthening, is a lighter version of the same procedure. It reshapes the gumline to make teeth look longer or more symmetrical, and it often involves only soft tissue removal without touching bone. Some practices quote cosmetic gum reshaping as low as $50 to $350 per tooth when the work is minimal. Multi-tooth cosmetic cases affecting the entire smile line typically start around $1,000 and go up from there. Because insurance won’t cover cosmetic work, this entire cost comes out of pocket.
How Long the Results Last
Crown lengthening has strong long-term outcomes when it’s done properly and the restored tooth is well maintained. A retrospective study of structurally compromised teeth that were saved with crown lengthening found a cumulative survival rate of 88.3% at five years, 78.4% at ten years, and 68.1% at fifteen years. The most common reasons for eventual failure were new cavities forming around the restoration (about 35% of failures), tooth fracture (30%), complications with the root canal (24%), and gum disease breakdown (11%).
Those numbers mean the procedure is a reasonable investment for preserving a tooth that might otherwise need extraction and an implant. An implant typically costs $3,000 to $5,000 or more, so crown lengthening plus a crown can be the more affordable long-term option if the tooth has a good prognosis. Patients with a high risk of cavities or fractures see lower success rates, so that’s worth discussing with your periodontist before committing.
How to Get an Accurate Estimate
Quoted ranges online, including the ones in this article, give you a ballpark but can’t replace a real estimate from a periodontist who has examined your mouth and reviewed your X-rays. Prices vary by region, by practice, and by exactly how much tissue and bone work your case requires. When you call for a consultation, ask for a breakdown that includes the surgery fee, any sedation costs, the follow-up visits, and the estimated cost of the final restoration. That full picture is the number that actually matters for your budget.