Gums: what they are, how they are structured, and what healthy gums look like

Your gums bleed when you brush your teeth, or it seems that "a gum has grown in the tooth" — and you immediately want to understand whether this happens to everyone or is already a problem. Let us break it down simply: what the gum is, what it consists of, and what normal looks like. So that you can compare it with your own and not guess.

Gums: what they are and what role they play in the mouth

The gum is the mucous membrane that covers the alveolar process of the upper jaw and the alveolar part of the lower jaw and surrounds the tooth in the area of the neck. Simply put, it is a cuff around the tooth: it surrounds it at the neck and covers the tissues that hold the tooth.

When people say "gum on the tooth" or "gum in the tooth," they usually mean the area at the neck where the gum is adjacent to the tooth. This is also where inflammation most often begins: plaque accumulates at the gum margin, irritates it, and it becomes red and bleeds.

How the gum is structured: its structure and connection to the tooth

On the outside, the gum is covered with stratified squamous epithelium, beneath which lies the lamina propria. The epithelium is not the same in different zones: at the interdental papillae and attached gingiva it is thicker and may keratinize; there, the basal, spinous, granular, and cornified layers are distinguished, and keratinized cells are constantly shed.

The gum surrounds the tooth in the area of the neck, and the interdental papilla fills the space between the teeth — which is why it may seem that the gum is "growing" in the tooth.

The interdental, or gingival, papilla is distinguished, as well as the marginal gingiva (free gingival margin), the alveolar, also called attached, gingiva, and the mobile gingiva. The basis of the gum in the cervical area is the stroma with a large number of collagen fibers — the circular ligament of the tooth. These fibers tightly press the gum to the tooth and evenly distribute chewing pressure.

What healthy gums look like

Healthy gums are without redness and swelling, fit tightly to the tooth, and do not bleed. The interdental papillae fill the spaces between the teeth. When you brush your teeth, use floss, or bite into a hard apple, there is no blood. There is also no bad breath or strange taste.

Red, swollen, painful gums that bleed when brushing are already inflammation. This is how gingivitis begins: the gums become red, swollen, and bleed easily. Gingivitis is usually reversible with daily brushing, flossing, and regular professional cleaning. If it is left untreated, it can progress to periodontitis: the gum pulls away from the tooth, pockets form, they become infected, and the bone, gum, and connective tissue holding the tooth are destroyed.

Which gum changes are considered a reason for examination

The list is short, and almost every point is familiar to many:

• gums bleed when brushing, when using floss, or when eating hard food;
• gums are painful, swollen, red;
• bad breath or an unpleasant taste has appeared;
• the gum recedes, tooth necks become exposed, teeth become loose;
• a child has painful or bleeding gums.

Separately — a lump on the gum or lip, ulcers, and red spots in the mouth: these require an urgent appointment, not home observation.

When to see a dentist

For a routine visit — if gums bleed when brushing or when eating hard food, if they hurt and are swollen, if there is bad breath, if a child has painful or bleeding gums. And even without complaints: an examination is needed if there has not been one for 2 years, and for a child under 18 years old — 1 year.

For an urgent visit — if the gums are very painful and severely swollen, teeth are loose or falling out, there are ulcers or red spots in the mouth, or a lump in the mouth or on the lip.

At the appointment, the dentist examines the teeth and gums and, if necessary, refers to a specialist for additional examinations. The approach is discussed after the examination, not chosen based on an article.

Gum problems by themselves are not a reason to call an ambulance; 103/112 — if the condition is life-threatening (general emergency signs: severe injury, sudden severe deterioration in well-being).

This material is for reference and does not replace a doctor's consultation: the gum cannot be assessed from a description and photograph; it is examined in the mouth.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer