Periodontology Anatomy - Gingival sulcus

The periodontium is the specialized tissues that provide two functions, surrounding and supporting the teeth. In addition to maintaining them within the maxillary and mandibular bones. The word is derived from the Greek terms peri-, which means "around" and -odont, which means "tooth". In a literary sense, periodontium translates to "around the tooth". Periodontics is the dental specialty that specifically docuses on the care and maintenance of these specific tissues. The specialty provides the support that is necessary to maintain functioning teeth. The practice consists of four main components which include the following:

1. Gingiva
2. Periodontal ligament (PDL)
3. Cementum
4. Alveolar bone proper

The tissues found in the periodontium combine together to form an active group of tissues. The alveolar bone is almost completely surrounded by the subepithelial connective tissue of the gingiva. The connective tissue of the gingiva is covered by the various characteristic gingival epithelia. The cementum, which overlays the tooth’s root, is attached to the adjacent cortical surface of the alveolar bone. It is attached by the alveolar crest, horizontal and oblique fibers of the periodontal ligament.

The gingival sulcus is the natural space located between the surface of the tooth and the surrounding gum or gingival tissue. The gingival sulcus is lined by the sulcular epithelium. Sulcus is Latin for groove. The depth of the sulcus is surrounded by two different entities which include: apically by the gingival fibers of the connective tissue attachment and coronally by the free gingival margin. A healthy depth is three millimeters or less. This depth allows patients to properly clean the area with a toothbrush or supplement the cleaning using other oral hygiene products.

The above diagram depicts the gingival sulcus as letter “G”.

Measuring the Sulcus

The depth of the sulcus helps dental professionals determine the health of your gums. The Journal of Health Sciences & Research explains that dental professionals may choose to conduct a periodontal assessment. This assessment aids in determining your risk for developing future gum disease. In order to measure the sulcus, a dental professional will use a small ruler, which is called a periodontal probe, and place the probe just below the gum tissue. The probe then enters the space which is referred to as the gingival sulcus. It gently presses against the area where the gum tissue connects to the tooth surface.

Pathology

When the sulcular depth is chronic in excess of three millimeters, regular hygiene practices at home may not be sufficient to properly clean the full depth of the sulcus. This can allow food debris and microbes to accumulate over time and form a dental biofilm. This creates a potential danger to the periodontal ligament (PDL) fibers which attach the gingiva to the tooth. If the accumulated microbes remain undisturbed in a sulcus for a long period of time, they can penetrate and ultimately destroy the delicate tissue and periodontal attachment fibers. If it left untreated over time, this can result in a deepening of the sulcus, gum recession, destruction of the periodontium, including the bony tooth socket, tooth mobility and even tooth loss. A periodontal pocket is a dental term which indicates an abnormally deep gingival sulcus.