Periodontology Anatomy - Gingiva
The gums or gingiva, consist of the mucosal tissue which lies over the mandible and maxilla inside the mouth. Gum health and the presence of gum disease can have a negative impact on a patient’s overall health.
Structure
The gums are part of the soft tissue lining which is located inside the mouth. The gums surround the base of the tooth and provide a seal around them. Unlike the soft tissues lining which is on the lips and cheeks, most of the gums are tightly bound to the underlying bone. This helps them to resist the friction of food passing over them. In cases of healthy gums, they act as an effective barrier to the plethora of periodontal insults to the deeper tissues. Healthy gums are usually a coral pink color in people who have lighter skin and may be slightly darker in people with melanin or have a darker pigmentation.
Any changes in the color of the gums, specifically any increased redness, combined with swelling and possible bleeding, can suggest inflammation. The inflammation is likely a result of the accumulation of bacterial plaque. The clinical appearance of the tissue reflects the underlying histology, in cases of both health and disease. When the gum tissue is not healthy, it can act as a direct gateway for periodontal disease. This can quickly advance into the deeper tissue of the periodontium. This can lead to a poor prognosis for maintaining the teeth. Both the type of periodontal therapies and home hygiene instructions given to patients from their dentist and restorative care are based on the gum tissue’s clinical condition.
The anatomy of gums are divided into three different categories which include marginal, attached and interdental areas.
Characteristics of Healthy Gums
Healthy gums are usually described as a coral pink color. Other colors like red, white and blue can indicate the presence of inflammation caused by gingivitis. Smoking tobacco or drug use can also result in this type of discoloration. While healthy gums are often described as a coral pink, there can be a variation in color for patients. This can be from various factors such as the thickness and the degree of keratinization of the epithelium, the amount of blood flowing to the gums, the natural pigmentation of the skin and underlying disease or medications.
Because the color of healthy gums can vary, a consistent color is more important than a particular color. Excess deposits of melanin can also cause the appearance of dark spots or patches on the gums. These dark spots can be especially prevalent at the base of the interdental papillae. Gum bleaching is a procedure that is often used in cosmetic dentistry to remove these dark spots.
Healthy gums typically have a smooth curved or scalloped appearance. Healthy gums also fill the space between the teeth. Swollen gum papilla is commonly seen in gingivitis. Healthy gums securely attach to the tooth. The gum surface of healthy gum also becomes narrow and thin at the free gingival margin. Inflamed gums, however, often have are puffy appearance.
Gums which are health will have a firm texture and be resistant to movement. The surface texture often demonstrates surface stippling. Unhealthy gums are often softer. Healthy gums will usually have the texture similar to an orange-peel from the stippling.