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Long overlooked, the periodontium plays a quintessential role in the health of the oral cavity. Composed of four anatomical structures, essential to supporting the tooth structure, these include gingiva, periodontal ligaments, cementum and alveolar bone (Wilkins, 2013). It is important that healthy gingiva is maintained in order to avoid progression into periodontal conditions. Healthy gingiva should cover the anatomical root portion of the tooth, till the cervical neck (Garcia-Godoy, Nathe, & Harris, 2012). Visual characteristics of healthy gingiva include a uniform stippled pink colour, however this can vary dependent on vascular supply and melanin pigmentation (Nield-Gehrig & Willmann, 2011). A division should be clear between the firm pink of the keratinised, stratified, squamous epithelium of the attached gingiva and the darker alveolar…show more content…
Infection occurs with the presence of biofilm - a living film of a community of bacteria (Fejerskov, Nyvad, & Kidd, 2015). These bacteria include aggregatibacter-actinomycetemcomitans, porphyromonas-gingivalis and tannerella-forsythia (Nield-Gehrig & Willmann, 2011). Although biofilm is essential for periodontal disease to occur, the primary cause to tissue destruction is the body's inflammatory response itself. Inflammation is the body's way of responding to a breach of the immune system, periodontal disease is no exception as this involves a pathogenic bacterial infection which prompts an inflammatory response which presents many signs and symptoms. If plaque is not removed by tooth brushing or flossing, this will stimulate an immunological responses. This is because bacteria excrete metabolic waste which will diffuse through the sulcus and be identified by the dendritic cells of the immune system as foreign (Nield-Gehrig & Willmann,

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