The
gingiva (sing. and
plur.In the English language, nouns are inflected for grammatical number—that is, singular or plural. This article discusses the variety of ways in which English plurals are formed for nouns...
:
gingiva), or
gums, consists of the mucosal tissue that lies over the alveolar bone.
Gingiva are part of the soft tissue lining of the mouth. They surround the teeth and provide a seal around them. Compared with the soft tissue linings of the lips and cheeks, most of the gingiva are tightly bound to the underlying bone and are designed to resist the friction of food passing over them.
The
gingiva (sing. and
plur.In the English language, nouns are inflected for grammatical number—that is, singular or plural. This article discusses the variety of ways in which English plurals are formed for nouns...
:
gingiva), or
gums, consists of the mucosal tissue that lies over the alveolar bone.
General description
Gingiva are part of the soft tissue lining of the mouth. They surround the teeth and provide a seal around them. Compared with the soft tissue linings of the lips and cheeks, most of the gingiva are tightly bound to the underlying bone and are designed to resist the friction of food passing over them. Healthy gingiva is usually coral pink, but may contain physiologic pigmentation. Changes in color, particularly increased redness, together with
edemaEdema or oedema , formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin, or in one or more cavities of the body...
and an increased tendency to bleed, suggest an
inflammationInflammation is the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli as well as initiate the healing process for the tissue. Inflammation is not a...
that is possibly due to the accumulation of
bacterial plaqueDental plaque is biofilm that builds up on the teeth. If not removed regularly, it can lead to dental cavities or periodontal problems ....
.
Subdivisions of gingiva
The gingiva is divided anatomically into marginal, attached and interdental areas.
Marginal gingiva
The marginal gingiva is the terminal edge of gingiva surrounding the teeth in collar like fashion. In about half of individuals, it is demarcated from the adjacent, attached gingiva by a shallow linear depression, the free gingival groove. Usually about 1 mm wide, it forms the soft tissue wall of the
gingival sulcusThe gingival sulcus is an area of potential space between a tooth and the surrounding gingival tissue and is lined by sulcular epithelium. The depth of the sulcus is bounded by two entities: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival...
. The marginal gingiva is supported and stabilized by the
gingival fibersThe gingival fibers are the connective tissue fibers that inhabit the gingival tissue adjacent to the teeth and help hold the tissue firmly against the teeth...
.
Attached gingiva
The attached gingiva is continuous with the marginal gingiva. It is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone. The facial aspect of the attached gingiva extends to the relatively loose and movable alveolar mucosa, from which it is demarcated by the
mucogingival junctionThe mucogingival junction is the interference between the more apically located alveolar mucosa and the more coronally located attached gingiva of the alveolus....
. Attached gingiva may present with
surface stipplingThe gingiva often possess a textured surface that is referred to as being stippled. Stippling only presents on the attached gingiva bound to underlying alveolar bone, not the freely moveable alveolar mucosa...
.
Interdental gingiva
The interdental gingiva occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact. The interdental gingiva can be pyramidal or have a "
colIn a range of hills, or especially of mountains, a pass is a path that allows to cross a mountain chain, it is usually a saddle point in between two areas of higher elevation. If following the lowest possible route through a range, a pass is locally the highest point on that route...
" shape.
Diseases of the gingiva
The gingival cavity
microecosystemMicroecosystems can exist in locations which are precisely defined by critical environmental factors within small or tiny spaces.Such factors may include temperature, pH, chemical milieu, nutrient supply, presence of symbionts or solid substrates, gaseous atmosphere etc.-Pond microecosystems:These...
, fueled by food residues and saliva, can support the growth of many microorganisms, of which some can be injurious to health. Improper or insufficient
oral hygieneTeeth cleaning is the removal of dental plaque from teeth, to prevent cavities , gingivitis, and periodontitis. It is part of a complete program of oral hygiene.-Brushing:...
can thus lead to many gingival and periodontal disorders, including
gingivitisGingivitis around the teeth is a general term for gingival diseases affecting the gingiva . As generally used, the term gingivitis refers to gingival inflammation induced by bacterial biofilms adherent to tooth surfaces.- Causes :Gingivitis can be defined as inflammation of the gingival tissue...
or
pyorrheaPeriodontitis refers to a number of inflammatory diseases affecting the periodontium — that is, the tissues that surround and support the teeth. Periodontitis involves progressive loss of the alveolar bone around the teeth, and if left untreated, can lead to the loosening and subsequent loss of...
, which are major causes for tooth failure. Recent studies have also shown that
Anabolic steroidAnabolic steroids, or anabolic-androgenic steroids , are a class of steroid hormones related to the hormone testosterone. They increase protein synthesis within cells, which results in the buildup of cellular tissue , especially in muscles...
s are also closely associated with gingival enlargement requiring a gingivectomy for many cases.
Color
Healthy gingiva usually has a color that has been described as "coral pink." Other colours like red, white, and blue can signify inflammation (
gingivitisGingivitis around the teeth is a general term for gingival diseases affecting the gingiva . As generally used, the term gingivitis refers to gingival inflammation induced by bacterial biofilms adherent to tooth surfaces.- Causes :Gingivitis can be defined as inflammation of the gingival tissue...
) or pathology. Although the text book color of gingiva is "coral pink", normal racial pigmentation makes the gingiva appear darker. Because the color of gingiva varies due to racial pigmentation, uniformity of color is more important than the underlying color itself.
Contour
Healthy gingiva has a smooth
arcuateArcuate can refer to:* Arcuate delta, a type of river delta* Arcuate fasciculus* Arcuate line* Arcuate nucleus* Arcuate nucleus * Internal and external arcuate fibers of the brain* Arcuate arteries of the kidney...
or scalloped appearance around each tooth. Healthy gingiva fills and fits each interdental space, unlike the swollen gingiva papilla seen in gingivitis or the empty interdental embrasure seen in periodontal disease. Healthy gums hold tight to each tooth in that the gingival surface narrows to "knife-edge" thin at the
free gingival marginThe free gingival margin is the interface between the sulcular epithelium and the epithelium of the oral cavity. This interface exists at the most coronal point of the gingiva, otherwise known as the crest of the marginal gingiva....
. On the other hand, inflamed gums have a "puffy" or "rolled" margin.
Texture
Healthy gingiva has a firm texture that is resistant to movement, and the surface texture often exhibits
surface stipplingThe gingiva often possess a textured surface that is referred to as being stippled. Stippling only presents on the attached gingiva bound to underlying alveolar bone, not the freely moveable alveolar mucosa...
(Orange peel appearance). Unhealthy gingiva, on the other hand, is often swollen and mushy.
Reaction to disturbance
Healthy gums usually have no reaction to normal disturbance such as brushing or periodontal probing. Unhealthy gums on the other hand will show
bleeding on probing250px|right|thumb|Straight [[periodontal probe]] at left, and Naber's probe on the right.Bleeding on probing is a term used by dentists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth...
(
BOPBOP or bop may refer to:* bop, a smack, strike, or punch*bop, a style to dance solo to Rockabilly or Blues music, Common since to 50s till today* bop, shortened form of Bebop, an early modern jazz developed in the 1940s...
) and/or purulent exudate (
pusPus is a whitish-yellow, yellow or yellow-brown exudate produced by vertebrates during inflammatory pyogenic bacterial infections. An accumulation of pus in an enclosed tissue space is known as an abscess, while a visible collection of pus within or beneath the epidermis is known as a pustule or...
).
Sources
- Willmann, Donald. PERI 5081 - Freshman Periodontics. UTHSCSA, 2006. 2.3.1
External links