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Clinical Features of Healthy and Diseased Gingiva

Apr 27, 2025

Chapter 5: Clinical Features of the Gingiva

Healthy Gingiva

  • Characteristics of Healthy Tissue

    • Free of inflammation
    • Not altered by disease/trauma
    • No bleeding on probing

  • Color

    • Pink or pigmented
    • Variations include light/dark pink

  • Attachment

    • Firmly bound to cementum and bone
    • Resilient: springs back if gently pressed

  • Texture

    • Stippled and firm
    • May resemble orange peel texture

  • Tissue Margin

    • Coronal to the CEJ (free gingival margin higher on the tooth)

  • Contour

    • Snug around tooth, firm against bone
    • Even scalloped look, knife-like or pointed interdental papilla
    • Variations in anterior vs. posterior sextant

  • Gingival Description in Clinical Notes

    • Use terms: color, contour, consistency, texture
    • Generalized vs. localized

Gingivitis

  • Definition

    • Form of periodontal disease
    • Typically caused by plaque biofilm
    • Inflammatory response to bacteria
    • Affects free and/or attached gingiva and/or interdental papilla

  • Types

    • Acute Gingivitis: Short duration
    • Chronic Gingivitis: May last years

  • Local Factors

    • Orthodontic bands, crown margins
    • Rotated teeth, calculus

  • Changes in Gingivitis

    • Color: Pink to red (see chart on page 90)
    • Contour/Size: Edema leads to false or pseudo pockets
    • Tissue Contour: Marginal and papillary redness, loss of scalloped appearance

  • Pictures

    • Early gingivitis
    • Slight marginal redness
    • Fiery red marginal gingiva (localized to gingival tissue)

  • Papilla Description

    • Bulbous/enlarged, blunted (flat), cratered (active disease state)

  • Consistency Changes

    • Increased tissue fluid, spongy texture
    • Leaves indentation upon probing
    • Deflects when blown with air

  • Texture Changes

    • Smooth, shiny appearance
    • Loss of stippling

  • Margin Position

    • Moves coronally due to swelling

  • Bleeding on Probing

    • Important inflammation indicator
    • Ulcerated sulcus becomes easily disrupted

  • Extent of Inflammation

    • Localized: Affects <30% of the mouth
    • Generalized: Affects >30% of the mouth
    • Papillary: Interdental papilla only
    • Marginal: Papilla and gingival margin
    • Diffuse: From papilla to margin to mucogingival junction

  • Pictures

    • Diffuse inflammation (localized in some areas)
    • Localized marginal/diffuse inflammation

Terms for Gingival Description

  • Use these descriptions in clinical notes to assess gingival health.

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