The gums, also called the gingiva, consist of the mucosal tissue which cover the mandible and maxilla located inside the mouth. The health of a patient’s gums is critical. When gum disease is present, it can have a negative impact on a patient’s oral health and overall wellbeing.
The gums are part of the soft tissue lining located inside the mouth. The gums surround the base area of the teeth and act as a seal around them. Unlike the soft tissues linings of the cheeks and lips, most of the gums are securely bound to the underlying bone. This aids in resisting the friction of food which frequently passes over them. In cases where a patient has healthy gums, they act as an effective barrier to the periodontal insults to the deeper tissues. Healthy gums are typically a coral pink color in people who have lighter skin and may be darker in people with melanin or who have a darker pigmentation.
Any changes in the color of the gums, specifically if there is increased redness, combined with swelling or bleeding, may suggest there is inflammation. Inflammation is often the result of an 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 unhealthy, it can act as a direct gateway to the mouth for periodontal disease. This can rapidly advance into the deeper tissue of the periodontium and result in a poor prognosis for maintaining a patient’s natural teeth. Both the type of periodontal therapies and home hygiene instructions which are shared with patients by their dentist and restorative care are based on the gum tissue’s clinical condition.
The anatomy of the gums are divided into three different categories. This includes marginal, attached and interdental areas.
Healthy Gum Characteristics
Healthy gums are usually described as having a coral pink color. Other colors such as red, white or blue may suggest inflammation is present which is typically caused by gingivitis. Smoking tobacco or the use of drugs can also result in discoloration. While healthy gums are often described as a coral pink, there can be a variation in the color of the gums for various patients based on their skin color. The varying color can be due to various factors including the thickness and the degree of keratinization of the epithelium, the amount of blood which flows to the gums, the natural pigmentation of the patient’s skin and any underlying health conditions or medications.
Because the color of healthy gums can vary, maintaining a consistent color is more important than focusing on one specific color. Excess deposits of melanin can result in the appearance of dark spots or splotches on the gums. These dark spots can be especially common at the base of the interdental papillae. Gum bleaching is a procedure that is often performed in cosmetic dentistry in order to remove these discolored spots.
Healthy gums will typically have a smooth curved or scalloped appearance. Healthy gums also fill the space found between the teeth. Swollen gum papilla is often found in cases of gingivitis. Healthy gums are securely attached to the tooth. The gum surface of a healthy gum also becomes narrow and thin at the free gingival margin. Inflamed gums, however, often are often puffy in their appearance.
Gums which are healthy have a firm texture and resist any movement. The surface of the gums often has a textured appearance which is referred to as stippling. Unhealthy gums are often softer and less firm. Healthy gums commonly have a texture similar to that of an orange-peel.