The blood and nerve supply of the gingiva are essential for maintaining its health and function. The gingiva rests on a well-organized system of blood vessels, lymphatic drainage, and nerves to provide nutrients, remove waste, and transmit sensory signals. 

Blood Supply of Gingiva

• Supraperiosteal arterioles: These arterioles arise from the crest of the alveolar bone and supply the facial and lingual surfaces of the gingiva. Capillaries from these vessels extend along the sulcular epithelium and between the rete pegs of the external gingival surface, ensuring proper oxygenation and nutrient distribution.
• PDL vessels: Blood vessels from the periodontal ligament extend into the gingiva and anastomose (connect) with capillaries in the sulcular area. This system ensures that the gingiva receives an adequate blood supply even when the tooth moves slightly during chewing or other activities.
• Arterioles from the crest of interdental septa: These arterioles run parallel to the crest of the bone and connect with the PDL vessels and other capillaries. The rich anastomosis helps maintain gingival health by efficiently delivering blood throughout the tissue, promoting healing and immune responses.

Lymphatic Drainage of Gingiva

• Labial and Lingual gingiva of mandibular incisors: Drains into the submental lymph nodes.
• Palatal gingiva of maxilla: Drains into the deep cervical lymph nodes.
• Buccal gingiva of maxilla: Drains into the submandibular lymph nodes.
• Buccal/Lingual gingiva of mandibular premolars-molars: Drains into the submandibular lymph nodes. 
• All teeth with adjacent periodontal tissues: Drain into the submandibular lymph nodes, except for the third molars and mandibular incisors. 
• Third molars: Drain into the jugulodigastric lymph nodes.

Nerve Supply of Gingiva

The nerve supply of gingiva provides the sensory input necessary for detecting temperature, pressure, and pain. The nerves of the gingiva follow the blood vessels and are organized based on the region of the oral cavity:

Labial aspect of maxillary incisors, canines, and premolars: Supplied by the superior labial branches from the infraorbital nerve.  

• Buccal gingiva in maxillary molar region: Supplied by branches of the posterior superior dental nerve. 
• Palatal gingiva: Supplied by the greater palatal nerve, and the incisor area is innervated by the long sphenopalatine nerve.