Gums

The gums are part of the soft tissue 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 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, 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. ==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, 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), 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, demonstrating an orange-peel like texture. Unhealthy gums, on the other hand, are often swollen and less firm. 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 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 steroids 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. It may indicate an underlying inflammation such as periodontitis or pyorrhea, 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==