The gums or gingiva (: gingivae) consist of the
mucosal tissue that lies over the
mandible
In jawed vertebrates, the mandible (from the Latin ''mandibula'', 'for chewing'), lower jaw, or jawbone is a bone that makes up the lowerand typically more mobilecomponent of the mouth (the upper jaw being known as the maxilla).
The jawbone i ...
and
maxilla
In vertebrates, the maxilla (: maxillae ) is the upper fixed (not fixed in Neopterygii) bone of the jaw formed from the fusion of two maxillary bones. In humans, the upper jaw includes the hard palate in the front of the mouth. The two maxil ...
inside the
mouth
A mouth also referred to as the oral is the body orifice through which many animals ingest food and animal communication#Auditory, vocalize. The body cavity immediately behind the mouth opening, known as the oral cavity (or in Latin), is also t ...
. Gum health and disease can have an effect on general health.
Structure
The gums are part of the
soft tissue
Soft tissue connective tissue, connects and surrounds or supports internal organs and bones, and includes muscle, tendons, ligaments, Adipose tissue, fat, fibrous tissue, Lymphatic vessel, lymph and blood vessels, fasciae, and synovial membranes.� ...
lining of the mouth. They surround the teeth and provide a seal around them. Unlike the soft tissue linings of the lips and cheeks, most of the gums are tightly bound to the underlying bone which helps resist the friction of food passing over them. Thus when healthy, it presents an effective barrier to the barrage of periodontal insults to deeper tissue. Healthy gums are usually coral pink in light skinned people, and may be naturally darker with melanin pigmentation.
Changes in color, particularly increased redness, together with swelling and an increased tendency to bleed, suggest an
inflammation
Inflammation (from ) is part of the biological response of body tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. The five cardinal signs are heat, pain, redness, swelling, and loss of function (Latin ''calor'', '' ...
that is possibly due to the accumulation of
bacterial plaque. Overall, the clinical appearance of the tissue reflects the underlying histology, both in health and disease. When gum tissue is not healthy, it can provide a gateway for periodontal disease to advance into the deeper tissue of the
periodontium
The periodontium () is the specialized tissues that both surround and support the teeth, maintaining them in the maxillary and mandibular bones. Periodontics is the dental specialty that relates specifically to the care and maintenance of the ...
, leading to a poorer prognosis for long-term retention of the teeth. Both the type of periodontal therapy and homecare instructions given to patients by dental professionals and restorative care are based on the clinical conditions of the tissue.
The gums are divided anatomically into marginal, attached and interdental areas.
Marginal gums
The marginal gum is the edge of the gums surrounding the teeth in collar-like fashion. In about half of individuals, it is demarcated from the adjacent, attached gums by a shallow linear depression, the free gingival groove. This slight depression on the outer surface of the gum does not correspond to the depth of the gingival sulcus but instead to the apical border of the junctional epithelium. This outer groove varies in depth according to the area of the oral cavity. The groove is very prominent on mandibular anteriors and premolars.
The marginal gum varies in width from 0.5 to 2.0 mm from the free gingival crest to the attached gingiva. The marginal gingiva follows the scalloped pattern established by the contour of the
cementoenamel junction (CEJ) of the teeth. The marginal gingiva has a more translucent appearance than the attached gingiva, yet has a similar clinical appearance, including pinkness, dullness, and firmness. In contrast, the marginal gingiva lacks the presence of stippling, and the tissue is mobile or free from the underlying tooth surface, as can be demonstrated with a periodontal probe. The marginal gingiva is stabilized by the
gingival fibers that have no bony support. The gingival margin, or free gingival crest, at the most superficial part of the marginal gingiva, is also easily seen clinically, and its location should be recorded on a patient's chart.
Attached gum
The attached gums are continuous with the marginal gum. It is firm, resilient, and tightly bound to the underlying periosteum of alveolar bone. The facial aspect of the attached gum extends to the relatively loose and movable
alveolar mucosa, from which it is demarcated by the
mucogingival junction. Attached gum may present with
surface stippling. The tissue when dried is dull, firm, and immobile, with varying amounts of stippling. The width of the attached gum varies according to its location. The width of the attached gum on the facial aspect differs in different areas of the mouth. It is generally greatest in the incisor region (3.5 to 4.5 mm in the maxilla and 3.3 to 3.9 mm in the mandible) and less in the posterior segments, with the least width in the first premolar area (1.9 mm in the maxilla and 1.8 mm in the mandible). However, certain levels of attached gum may be necessary for the stability of the underlying root of the tooth.
Interdental gum
The interdental gum lies between the teeth. They occupy the gingival
embrasure, which is the interproximal space beneath the area of tooth contact. The
interdental papilla
The interdental papilla, also known as the interdental gingiva, is the part of the gums (gingiva) that exists coronal to the free gingival margin on the mesial and distal surfaces of the teeth. The interdental papillae fill in the area betw ...
can be pyramidal or have a "
col" shape. Attached gums are resistant to the forces of
chewing and covered in
keratin
Keratin () is one of a family of structural fibrous proteins also known as ''scleroproteins''. It is the key structural material making up Scale (anatomy), scales, hair, Nail (anatomy), nails, feathers, horn (anatomy), horns, claws, Hoof, hoove ...
.
The col varies in depth and width, depending on the expanse of the contacting tooth surfaces. The
epithelium
Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...
covering the col consists of the marginal gum of the adjacent teeth, except that it is nonkeratinized. It is mainly present in the broad interdental gingiva of the posterior teeth, and generally is not present with those interproximal tissue associated with anterior teeth because the latter tissue is narrower. In the absence of contact between adjacent teeth, the attached gum extends uninterrupted from the facial to the lingual aspect. The col may be important in the formation of periodontal disease but is visible clinically only when teeth are extracted.
[Fehrenbach, MJ and Popowics, T. (2026).''Illustrated Dental Embryology, Histology, and Anatomy'', Elsevier, pages 138-39.]
Characteristics of healthy gums
Color

Healthy gums usually have a color that has been described as "coral pink". Other colours like red, white, and blue can signify inflammation (
gingivitis) or pathology. Smoking or drug use can cause discoloring as well (such as "
meth mouth"). Although described as the colour coral pink, variation in colour is possible. This can be the result of factors such as: thickness and degree of keratinization of the
epithelium
Epithelium or epithelial tissue is a thin, continuous, protective layer of cells with little extracellular matrix. An example is the epidermis, the outermost layer of the skin. Epithelial ( mesothelial) tissues line the outer surfaces of man ...
, blood flow to the gums, natural pigmentation of the skin, disease, and medications.
Since the colour of the gums can vary, uniformity of colour is more important than the underlying color itself. Excess deposits of melanin can cause dark spots or patches on the gums (melanin gingival
hyperpigmentation
Hyperpigmentation, also known as the dark spots or circles on the skin, is the darkening of an area of Human skin, skin or nail (anatomy), nails caused by increased melanin.
Causes
Hyperpigmentation can be caused by sun damage, inflammation, or ...
), especially at the base of the interdental papillae.
Gum depigmentation (aka gum bleaching) is a procedure used in cosmetic dentistry to remove these discolorations.
Contour
Healthy gums have a smooth curved or scalloped appearance around each tooth. Healthy gums fill and fit each space between the teeth, unlike the swollen gum papilla seen in gingivitis or the empty interdental
embrasure seen in periodontal disease. Healthy gums hold tight to each tooth in that the gum surface narrows to "knife-edge" thin at the
free gingival margin. On the other hand, inflamed gums have a "puffy" or "rolled" margin.
Texture
Healthy gums have a firm texture that is resistant to movement, and the surface texture often exhibits
surface stippling. Unhealthy gums, on the other hand, are often swollen and less firm. Healthy gums have an orange-peel like texture to it due to the stippling.
Reaction to disturbance
Healthy gums usually have no reaction to normal disturbance such as brushing or
periodontal probing. Unhealthy gums, conversely, will show
bleeding on probing (BOP) and/or
purulent exudate.
Clinical significance
The gingival cavity
microecosystem, 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 hygiene
Oral hygiene is the practice of keeping one's oral cavity clean and free of disease and other problems (e.g. bad breath) by regular brushing of the teeth (dental hygiene) and adopting good hygiene habits. It is important that oral hygiene be carr ...
can thus lead to many gum and periodontal disorders, including
gingivitis or periodontitis, which are major causes for tooth failure. Recent studies have also shown that
anabolic steroid
Anabolic steroids, also known as anabolic-androgenic steroids (AAS), are a class of drugs that are structurally related to testosterone, the main male sex hormone, and produce effects by binding to the androgen receptor (AR). Anabolism, Anaboli ...
s are also closely associated with
gingival enlargement requiring a gingivectomy for many cases.
Gingival recession is when there is an apical movement of the gum margin away from the biting (occlusal) surface.
Gingival Recession - Causes and treatment
JADA, Vol 138. http://jada.ada.org . Oct 2007. American Dental Association It may indicate an underlying inflammation such as periodontitis[mexicodentaldirectory.com: dental sensitivity](_blank)
Retrieved on August 2010 or pyorrhea,[ a pocket formation, dry mouth][ or displacement of the marginal gums away from the tooth by mechanical (such as brushing),][ chemical, or surgical means.][Mondofacto medical dictionary > gingival retraction]
05 Mar 2000 Gingival retraction, in turn, may expose the dental neck and leave it vulnerable to the action of external stimuli, and may cause ''root sensitivity''.[
]
See also
* Gum graft
* Head and neck anatomy
* Periodontitis
References
External links
*
{{Authority control
Gingiva
Periodontology
Human mouth anatomy