Gums: Structure, Function & Diseases

Gums are the part of the oral mucosa that covers the teeth from the jawbone to the crowns. The gums ensure that the teeth are firmly anchored in the mouth, and they protect the jaw and the roots of the teeth from bacterial infections and the penetration of foreign bodies. The gums are an important part of the oral anatomy, so it is essential to take good care of them to maintain the health of the oral cavity.

What are gums?

Schematic structure of the tooth and its components. Click to enlarge. The gums (Latin: gingiva) are located in the mouth and are the part of the oral mucosa that covers the jaws and protectively surrounds the lower part of the teeth. As part of the tooth-supporting apparatus, it ensures, together with the roots of the teeth, that the teeth sit firmly in the mouth. Healthy gums lie close to the necks of the teeth, completely filling the spaces between the teeth and thus serving as a kind of seal. Compared to the soft oral mucosa found inside the cheeks and lips, most of the gums are firmly attached to the underlying jawbone, making them very resilient and able to withstand the friction of grinding food without suffering damage.

Anatomy and structure

Histologically, i.e., tissue-wise, the gum consists of a covering tissue (squamous epithelium) comprising a few layers of horny tissue. A subcutis is absent, so it cannot be displaced. The gingiva is anatomically divided into free, attached and interdental gingvia. Free gingvia is the gingival margin that surrounds the teeth like a collar or cuff. It has a thickness of about 1 millimeter and is supported and stabilized by the gingival fibers and includes the interdental gingival papillae. The attached gingvia is connected to the free gingvia without gaps; it is firm, robust, and closely connected to the underlying alveolar bone by connective tissue fibers. Coronally, it is bounded by the free gingival groove, apically by the mucogingival border. Interdental gingvia is the gum that is located between each tooth and is shaped like a triangle.

Functions and tasks

Due to the absence of a subcutaneous layer, the gums are firmly attached and cannot be displaced, thus ensuring that the teeth are securely anchored in the oral jaw. In addition, the gums have the task of forming a kind of seal that prevents bacteria, plaque, food pulp, and various other pathogens and foreign bodies from entering the roots of the teeth, where they could cause infection or injury. Healthy gums are pale pink in color, have an orange-like, dentate surface, and tightly surround the necks of the teeth. It completely fills the spaces between teeth and does not bleed easily when eating or brushing with a toothbrush. To ensure that it remains healthy and can perform its protective function undisturbed, it is important to clean it of bacteria and food debris by brushing at least twice a day. Attention should also be paid to cleaning the interdental spaces. The daily use of dental floss, interdental brushes or interdental wooden sticks is suitable for this purpose. An electric toothbrush is sometimes more gentle on the gums than brushing with a manual toothbrush and also generally cleans more thoroughly.

Diseases

When a patient’s gums are chronically inflamed, the condition is called gingivitis or gingivitis. This disease is very common in the population (affecting 80% of all adults), usually occurs due to poor oral hygiene, and is caused by bacteria and dental plaque (plaque). Factors that promote plaque formation, in addition to inadequate oral hygiene, are an insufficient amount of saliva, teeth that are too close together and carious tooth damage, protruding filling and crown margins, and an unbalanced diet that involves too little chewing. Good oral hygiene and a healthy diet can have a preventive effect. Symptoms of gingivitis include a color change in the gums, swelling and bleeding. The gums are red, sensitive and bleed easily after eating or dental care. Thickened gum pockets also form around the gums.Gingivitis can lead to complications such as serious inflammation and must be treated by a dentist without fail, otherwise periodontitis can develop. Good dental treatment can stop inflammation if diagnosed early. Untreated periodontitis can lead to the loss of the affected tooth, because the jawbone in which the neck of the tooth and the root of the tooth are embedded is broken down and the tooth loses its firm hold in this way and falls out. X-rays are often taken to detect damage to the jawbone.