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Gums are the pink tissue that surrounds the base of our teeth and helps keep them in place. They are divided into marginal, attached, and interdental areas. While gums are not muscles, the alveolar mucosa, or looser gum below the attached gingiva, does contain muscle. This muscle allows for the movement of the cheeks and lips. In this text, we will explore the different parts of the gums and their functions, as well as the importance of maintaining good gum health.
| Characteristics | Values |
|---|---|
| Gums | Tissue that surrounds the base of teeth and helps keep them in place |
| Gum tissue types | Marginal, attached, and interdental |
| Marginal gum | The edge of the gums surrounding the teeth in a collar-like fashion |
| Attached gum | Continuous with the marginal gum, firm, resilient, and tightly bound to the underlying periosteum of the alveolar bone |
| Interdental gum | Lies between the teeth and occupies the gingival embrasure |
| Gum health | Healthy gums are pink, firm to the touch, and act as a barrier to periodontal disease |
| Gum recession | Occurs when there is insufficient attached gum, causing the gum to slowly recede over time |
| Treatment for gum recession | Gingival grafting, where a small piece of attached gingiva is transplanted to the affected area |
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What You'll Learn
Gum tissue anatomy
The gums, or gingiva, are made up of mucosal tissue that lies over the mandible and maxilla inside the mouth. They are part of the soft tissue lining inside the mouth and surround the base of the teeth, acting as a seal. The gums are tightly bound to the underlying bone, which helps them resist the friction of food passing over them.
Healthy gums are typically coral pink in light-skinned people, and may be naturally darker with melanin pigmentation. They are also smooth, curved, or scalloped in appearance and fit securely into each space between the teeth. However, the colour of healthy gums can vary, and a uniform colour is more important than the specific underlying colour. Excess deposits of melanin can cause dark spots or patches on the gums, which can be removed through gum depigmentation or gum bleaching.
The gums are divided anatomically into three areas: marginal, attached, and interdental. The marginal gum is the edge of the gums that surrounds the teeth in a collar-like fashion. It is demarcated from the attached gums by a shallow linear depression called the free gingival groove. The marginal gingiva is the strip of soft tissue that surrounds the neck of the teeth and is mobile or free from the underlying tooth surface. It is stabilized by the gingival fibres that have no bony support.
The attached gums are continuous with the marginal gum and are firm, resilient, and tightly bound to the underlying periosteum of the alveolar bone. The width of the attached gum varies according to its location, with the greatest width typically in the incisor region. The interdental gum lies between the teeth and occupies the gingival embrasure, which is the interproximal space beneath the area of tooth contact.
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Gum health
The gums are the pink tissue just above and below your teeth. They are divided anatomically into marginal, attached, and interdental areas. Marginal gums are the edge of the gums that surround the teeth in a collar-like fashion. Attached gums are continuous with the marginal gum and are firm, resilient, and tightly bound to the underlying periosteum of the alveolar bone. The interdental gum lies between the teeth and occupies the interproximal space beneath the area of tooth contact.
Healthy gums are usually coral pink in light-skinned people and may be naturally darker with melanin pigmentation. They are an important barrier to the deeper tissue of the periodontium, which is the soft connective tissue (periodontal ligament) that lines your tooth socket. When gum tissue is not healthy, it can provide a gateway for periodontal disease to advance into the deeper tissue, leading to a poorer prognosis for long-term tooth retention.
Gum disease starts when plaque, a sticky film-like substance filled with bacteria, builds up under and along the gum line. It can cause infections that hurt the gum and bone, leading to gum disease and tooth decay. The effects of gum disease range from mild redness and swelling of the gums (gingivitis) to complete destruction of the tooth's bony support structure (advanced periodontitis), which is responsible for tooth loss.
To keep your gums healthy, it is recommended to brush your teeth at least twice a day, floss at least once a day, and see a dentist twice a year. Using a toothbrush with soft bristles and choosing a toothpaste that contains fluoride can also help improve gum health. Additionally, it is important to maintain a healthy diet rich in vegetables, vegetable oils, fruits, legumes, nuts, and fatty fish, as these foods provide essential nutrients and help suppress inflammation.
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Gum disease
Gums are the pink tissue just above and below the teeth. They are divided anatomically into marginal, attached, and interdental areas. The marginal gum is the edge of the gum that surrounds the teeth, while the attached gum is a second layer of soft tissue that is immovable and tough. The interdental gum lies between the teeth.
The warning signs of gum disease include red, swollen, or tender gums, bleeding while brushing, flossing, or eating hard food, and gums that are receding or pulling away from the teeth. This can cause the teeth to appear longer. Gum disease is often silent, and symptoms may not appear until the advanced stages. However, it is important to protect your gums from this disease to prevent tooth and bone loss.
Gingivitis is the mildest form of gum disease, causing the gums to become red, swollen, and easily bleed. It is reversible with professional treatment and good oral care at home. Untreated gingivitis can advance to periodontitis, a more severe form of gum disease. With time, plaque can spread and grow below the gum line, leading to a chronic inflammatory response that breaks down the tissues and bones supporting the teeth.
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Gum recession
The first signs of gum recession are usually tooth sensitivity or a tooth appearing longer than normal. A notch may also be felt near the gum line. The main sign of gum recession is the gums appearing to shrink away from the teeth. The exposed roots may appear darker than the crown of the tooth.
The gum consists of marginal, attached, and interdental areas. Gum recession occurs when the attached gingiva, which is the part of the gum that covers the bone and connective tissue anchoring the teeth in place, starts to separate from the root surface of the tooth. This exposes the weaker cementum, which can decay or erode at a faster pace than enamel, increasing the risk of sensitivity and cavities.
The causes of gum recession include poor oral hygiene, hormonal changes, genetics, misaligned teeth, teeth grinding or clenching, trauma, tobacco use, and certain medications. Poor oral hygiene leads to a buildup of bacteria, plaque, and tartar, which can cause gum inflammation and disease, resulting in gum recession. Aggressive or incorrect brushing and flossing can also directly cause gum recession.
Treatment options for gum recession include medications, surgical procedures, and improving oral hygiene. Mild cases of gum recession may be treated with deep cleaning, also known as tooth scaling and root planing, to remove plaque and tartar and smooth the exposed root. In more severe cases, gum surgery may be required, such as open flap scaling and root planing or regenerative procedures to restore lost bone and tissue.
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Gum grafting
Gums are the pink tissue just above and below the teeth. They are divided anatomically into marginal, attached, and interdental areas. The marginal gum is the edge of the gums that surrounds the teeth. The attached gum is continuous with the marginal gum and is firm, resilient, and tightly bound to the underlying periosteum of the alveolar bone. The interdental gum lies between the teeth and occupies the gingival embrasure.
There are three common types of gum tissue grafts: connective-tissue grafts, free gingival grafts, and pedicle grafts. In connective-tissue grafts, the most common method, a flap of skin is cut on the roof of the mouth, and tissue from under the flap is removed and stitched to the gum tissue surrounding the exposed root. Free gingival grafts are similar but use tissue directly from the roof of the mouth. This method is often used for patients with thin gums who need additional tissue to prevent further recession. In pedicle grafts, a flap of tissue is created from an area near the gum recession and used to cover the exposed root. This procedure does not cut off the blood flow in the mouth and is usually the most successful.
After the procedure, patients should eat soft, cool foods for one to two weeks to aid the healing process. The amount of pain and discomfort depends on the type of gum graft performed. If tissue is removed from the palate, some discomfort may be experienced for a few days. Over-the-counter anti-inflammatory medication or prescription pain medication can help manage pain.
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Frequently asked questions
Gums are the pink tissue just above and below your teeth. They are divided anatomically into marginal, attached, and interdental areas. Gums help keep your teeth in place and protect the part of your jawbone that supports your teeth.
Gum recession is when the gum slowly recedes over time, even when the patient is very conscientious about their oral health. This is due to a lack of attached gum, which results in the muscle pulling down on the gum margin.
Gum recession can be treated with a frenectomy, which involves surgically releasing the frenum from the gum. A new band of hard gum is then added to re-establish an adequate amount of attached gum.
