The gingiva, is a critical component of the oral cavity. Defined as the part of the oral mucosa that covers the alveolar processes of the jaws and surrounds the neck of the teeth, the gingiva serves essential roles in protecting and supporting the underlying bone and teeth. Understanding the macroscopic features of gingiva can help us assess oral health more accurately and diagnose periodontal diseases early.

The gingiva is divided into three main regions, each with specific functions and characteristics: 

 1. Marginal Gingiva: This is the terminal edge of the gingiva that surrounds the teeth, forming a cuff around them. It is not directly attached to the underlying bone or tooth, making it more prone to movement. 

 2. Attached Gingiva: As the name suggests, this part of the gingiva is firmly attached to the alveolar bone. It provides strength and stability to the gingiva, resisting trauma from chewing. 

 3. Interdental Gingiva: This is the gingival tissue that occupies the space between adjacent teeth. Its shape varies based on the position and contact points of the teeth, creating the papilla.

Gingival Sulcus: A Vital Diagnostic Feature

The gingival sulcus is the shallow space between the marginal gingiva and the tooth surface. 

This space has three primary boundaries: 

 - Inner boundary: The tooth surface. 

 - Outer boundary: The sulcular epithelium, a thin, non-keratinized tissue.

 - Base: The coronal margin of the attached tissue, which defines the depth of the sulcus.

The clinical assessment of the macroscopic features of gingiva provides essential insights into periodontal status. The following are key clinical parameters:

 - Color: Healthy gingiva is typically coral pink, though it can vary depending on the individual's melanin levels. Inflammation may cause redness, indicating gingivitis. 

- Contour: The marginal gingiva should have a knife-edged contour that adapts closely to the tooth. Swollen or rolled contours could indicate inflammation. 

- Consistency: Healthy gingiva is firm and resilient. Soft or spongy gingiva could be a sign of infection or trauma.

- Size: Gingival size may change in response to disease. Increased size is often seen in gingival hyperplasia, while recession results in a reduction in the gingival margin.

- Shape: Healthy gingiva follows the scalloped contours of the teeth, with sharp, pointed interdental papillae. 

- Surface Texture: The attached gingiva has a stippled appearance, similar to the texture of an orange peel. Loss of stippling can be an early sign of inflammation. 

- Bleeding on Probing (BOP): BOP is a reliable indicator of gingival inflammation. The absence of bleeding suggests healthy gingiva, while bleeding indicates the presence of periodontal disease. 

- Position: The gingival margin should be located slightly above the cementoenamel junction. A receded or abnormally positioned margin could indicate periodontal disease or trauma.