Dental papilla and its changes

Teeth are held in their sockets by ligaments but also by the gums, especially the fixed gums which are intimately attached to the tooth socket.

The gum has the following components:

  • Marginal gingiva – represents the most superficial portion of the gingiva which is in the immediate vicinity of the dental cartilage. It is sensitive and if it is injured or there is an increased concentration of bacterial plaque in the vicinity, it reacts with inflammation and bleeding. Often, in gum disease, bleeding can occur even before the inflammation is clinically detectable.

  • Dental papilla – is the portion of the marginal gingiva that lies between the teeth.

  • Fixed gingiva – continues apically and covers the tooth roots and underlying bone.

The dental papilla is a portion of the marginal gingiva that lies between the teeth. Contacts between neighboring teeth are mostly punctiform in young people and over a larger area in adults, due to the wear that occurs with advancing age.

The shape and size of the papilla depend on the area in which it is located and also on constitutional features or certain malformations.

  • In front teeth, the papilla has a triangular shape occupying the space below the contact point.

  • In front teeth, the papilla has a more extended, elongated size in line with the dental volume.

Occlusal anomalies can influence the shape of the papilla in the following ways:

Crowded dental disarrangements occur when teeth have very close contacts with each other, often overlapping. Thus, the dental papilla is reduced in volume and bulges due to lack of space. If poor hygiene with bacterial plaque build-up is added to the crowding, the papilla bleeds easily.

Dental gaps with the existence of spaces – with the existence of spaces between teeth, when chewing, food will impact the papillae. Normally, the contact points between the teeth are a protective element of the papillae, which will not bear the impact produced during chewing. Thus, in the absence of interdental protection, the papillae will be traumatized. They will flatten, lose their characteristic pyramid shape and a layer of keratin will be deposited on their surface to increase their strength.

Masticatory trauma will reduce their volume and they will no longer fit closely to the teeth, and gingival recession may occur. With receding gums, dental hypersensitivity may also occur.

The dental papilla increases with the development of the jaws and is closely related to the development of the alveolar bone.

In children and young people, under periodontal health conditions it has a light pink color. With advancing age, due to bone resorption and gingival retraction, the papilla reduces in volume and the visible surface area of the teeth increases.

A papilla found in the vicinity of an increased deposit of bacterial plaque will suffer inflammation which, in the early stages, is reversible by instituting sanitization.

Hygienisation is carried out primarily by the patient at home by brushing and by the additional means of flossing or oral douching. Also, during visits to the dentist, hygiene is supplemented by scaling.

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