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Published September 2026

1 of 5This tooth is broken off close to the gum, with little left to hold on to
  1. This tooth is broken off close to the gum, with little left to hold on to
  2. The area is numbed
  3. A small amount of gum, and sometimes a little bone, is trimmed away
  4. More of the tooth now stands clear of the gum line
  5. A filling or a crown now has enough tooth to hold on to

Who usually does it

periodontist. Often done by the general dentist for one tooth; a periodontist for larger areas.

One question worth asking

Will the gum stay at this level, or does it move while it heals?

Crown lengthening with bone removal

Cleanings and gum careMajorD4249

D4249. Gum and a little bone are removed so a crown can grip a tooth broken near the gum line; the usual crown lengthening code.

Removing or reshaping gum tissue, and sometimes a little bone, to expose more of a tooth. Dentists do it to make room for a filling or crown, to fix a gummy smile, or to remove gum growing over an erupting tooth.

The gum, and sometimes a rim of bone, is trimmed back so more of the tooth stands clear. Dentists do it to reach decay that runs under the gum, to give a crown something to grip, to even out a gummy smile, or to free a tooth that gum has grown over. One tooth is a single visit; larger areas are done a quarter of the mouth at a time and need healing time before a crown is made.

Codes for this

D4210MajorGum reshaping, four or more teethTrims and reshapes overgrown gum across most of a quarter of the mouth.per quadrant · Done sometimesD4211MajorGum reshaping, one to three teethThe same trimming for a few teeth.per quadrant · Done sometimesD4212BasicGum trimming to reach a cavityA little gum is removed so the dentist can reach a cavity or crown edge; done the same day as the filling.per tooth · Done sometimesD4230MajorGum-only crown lengthening, four or more teethExposes more tooth by removing gum only, no bone, across most of a quarter.per quadrant · Rarely doneD4231MajorGum-only crown lengthening, one to three teethThe same gum-only exposure for a few teeth.per quadrant · Rarely doneD4249MajorCrown lengthening with bone removalGum and a little bone are removed so a crown can grip a tooth broken near the gum line; the usual crown lengthening code.per tooth · Done sometimesD7970BasicRemoving excess gum or scar tissueRemoves overgrown or scarred soft tissue, often under a denture.per arch · Rarely doneD7971BasicRemoving a gum flap over an erupting toothTrims the flap of gum that traps food over a partly erupted tooth, often a wisdom tooth.per tooth · Done sometimes

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Crown lengthening with bone removal (D4249): what happens, step by step | TruthMolar