October 5, 2022

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Gingival Sulcus: Definition, Depth, Treatment, More

5 min read

The gingival sulcus (or gingival crevice) is that little ridge in your mouth where your teeth meet your gums.

Keeping it clean is crucial for gum and tooth health. Good oral hygiene is important — and the more you know about your mouth, the better you can take care of it throughout your life.

That includes taking steps to prevent oral conditions like gingivitis or periodontitis.

Read on to learn more about your gingival sulcus and how to keep it as healthy as possible as part of your daily oral health hygiene habits.

The gingival sulcus is the relative space between each tooth and the gum tissue that surrounds it. It’s a small, V-shape groove around the base of a tooth.

At the bottom of the sulcus is the cementoenamel junction. This area helps the gums stay attached to the surface of your teeth.

When it’s healthy, the gingival sulcus is snug around your teeth from the base of the tooth all the way to where the tooth emerges from your gums. This leaves very little room for any external substances, like food, to enter in the space between the gum and the tooth.

When it’s unhealthy or diseased, the space between the sulcus and the tooth is a little larger. This allows substances to enter that space more easily.

The gingival sulcus ultimately helps protect your gums from infection or disease. If your gums get diseased, you can experience problems relating to both the tooth and gums, such as:

  • gums that pull away from your teeth
  • loose teeth
  • pain
  • changes in your teeth

A sulcus between 1 and 3 millimeters (mm) deep is considered standard in most people. But any depth of more than 3 to 4 mm may be a sign of gum disease.

Your gums change over time with inflammation and aging as well as individual differences in people. But in every person, this relative depth of the gingival sulcus is an important part of assessing how healthy the area is.

Measuring the depth of the gingival sulcus helps dental practitioners diagnose gum disease and evaluate treatment options.

A dentist will check your gums for disease during a regular dental exam. They may order X-rays to evaluate or monitor bone loss.

To measure the gingival sulcus depth, the dentist will use a small ruler to gently probe your gums to check for inflammation and measure the sulcus around each tooth. To do this, they will place the ruler just under the gum tissue.

There are six main areas in your mouth, called sextants, according to the British Society of Periodontology. Three belong to the maxillary arch (upper jaw) and three belong to the mandible (lower jaw).

The sextants are:

  • top right
  • top anterior
  • top left
  • bottom right
  • bottom anterior
  • bottom left

After probing your gums, the dentist will note the highest score for each sextant in a range of 0 to 4, where 0 means no gum treatment is necessary and 4 requires:

  • oral hygiene instructions
  • cleaning treatments
  • evaluation of whether more complex treatment is necessary
  • potential referral to a specialist

Different conditions can affect the gingival sulcus. Knowing more about each of these can help keep your gums healthy.

Gingival hyperplasia

In gingival hyperplasia, there’s an overgrowth of gum tissue around the teeth.

This typically results from poor oral hygiene or some medications. If untreated, it can impair the alignment of your teeth and increase the risk of gum disease.

Symptoms can include:

  • tender gums
  • inflammation
  • pain
  • bad breath
  • plaque buildup

Gingivitis and periodontitis

Gingivitis is an inflammation of the gums, often caused by a bacterial infection.

If it goes untreated, it can then become a more serious condition called periodontitis. Food and plaque getting trapped in the sulcus can cause these conditions.

Symptoms can include:

  • red, tender, swollen gums
  • bleeding gums
  • loose teeth
  • pain when chewing
  • dentures don’t fit anymore
  • bad breath that doesn’t go away with brushing

Cavities

Cavities, or decayed areas of the tooth that eventually form holes, can also affect your gums and gingival sulcus.

A cavity in the root of a tooth below the gums can affect the gums around the tooth. If tooth decay is severe, pus can build up around the tooth because your body is reacting to and fighting bacteria.

Symptoms can include:

  • toothache
  • pain with cold, hot, or sweet things
  • visible holes or black spots on your teeth
  • pain when you bite down

Treatment depends on the specific gum disease or tooth issue you have, but good oral hygiene is a must for healthy gums and teeth.

A dental professional may perform a deep cleaning of your teeth to remove all plaque and tartar. This helps prevent gum irritation and may include:

  • Scaling. Scaling is a process for removing tartar from above and below the gum line.
  • Root planing. A dental professional will smooth rough spots and remove plaque and tartar from the root of a tooth.
  • Lasers. Lasers help dentists remove tartar without using abrasive tools on tooth surfaces.

Medications may also be used to treat gum disease, including:

  • antiseptic mouthwash
  • timed-release antiseptic chips
  • antibiotic microspheres inserted into gum pockets after scaling and planing
  • oral antibiotics, such as doxycycline

With severe disease, a dental professional may recommend flap surgery.

During this procedure, the surgeon will move the gums back in order to remove plaque from pockets. They’ll then sew the gums back around the tooth.

Good oral hygiene can help keep your teeth and gums healthy and prevent gum disease. Everyday tips include:

  • regularly brushing teeth at least twice daily with fluoride toothpaste
  • flossing regularly or using a water pick or water flosser
  • having regular dental check-ups and cleanings
  • avoiding smoking and other inhaled tobacco or vapor products

Talk with a doctor or dentist if you have questions about your oral health or hygiene routine, especially if you’re noticing tooth or gum conditions even with regular hygiene.

Gum disease doesn’t affect just your mouth and teeth. It has also been associated with other health conditions, like heart disease and stroke.

Oral health contributes to your overall health, so keeping your teeth and gums healthy helps keep you healthy in general.

Keeping your teeth clean, practicing good oral hygiene, and seeing your dentist for regular cleanings and check-ups can all keep your mouth and gums healthy, including your gingival sulcus.

Talk with a dentist or periodontist if you have questions about your oral hygiene or your gum health. They can show you techniques to improve your gum care and help you keep your gums and gingival sulcus healthy.

https://www.healthline.com/health/gingival-sulcus

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