Do crowns always need crown lengthening? i'm going to need two crowns, the first i've ever had, and was told that i'm going to need crown lengthening, which sounds really painful. is this a common thing with crowns?

First : First of all let me say that I have done hundreds of crown lengthenings without having patients in significant post-operative pain. Not all teeth requiring crowns need lengthening but if there is insufficient tooth structure left or if there is decay or damage too close to the supporting bone, placement of a crown would result in long term inflammation because ther would not be enough room for healthy gum supporting structures to form around the new crown. I actually see more crowns placed where a crown lenghtening should have been done but wasn't. I can't diagnose without seeing your particular situation but i applaud a dentist who recognizes the need to prepare the gums properly before crown placement. If unsure, get a second opinion.

Dr : Dr scharf gave you a really good synopsis of crown lengthening. Also, keep in mind that the support structure (bone) around the tooth needs to be maintained. I, too, have performed this procedure many times, but at a point, if too much bone needs to be removed, the crown/root ratio becomes unfavorable. Discuss your concerns with your dentist, who has physically examined you for this procedure.

Dr. : Dr. Scharf has already given you an answer i can agree with. I would like to address the 2 last parts of your question. Today, intraoral treatments are almost always done with some form of local anesthetic so the procedure itself should not only be pain free but feeling free. Postoperatively, as the area heals sensation gradually returns and the area becomes normal feeling again. Rarely does a patient need more than over-the-counter pain meds for the usual minimal discomfort experienced after these procedures. A quality practitioner should be aware of your concerns and address them accordingly. Personally speaking, i had a crown lengthening done on myself by a colleague and don't remember it to be a painful experience. Your question about commonality of this procedure is interesting. As I am a periodontist who also does crowns (not-limited to periodontics) i can only speak from personal experience. In my office, probably less than 5% of the crowns that I do get crown lengthenings. Other practitioners may fine that figure low or some may find it high. As this is your first experience needing what some may call "advanced" dentistry, i can understand your concern about these procedures. They certainly may be necessary in your case but it wouldn't hurt to ask your practitioner about possible alternative procedures.