Tobias K. Boehm (February 16, 2026)
The two types of tissue near teeth: Pale-pink gingiva (underneath probe) and red-pink mucosa (beyond tip of probe). The line where the two types of tissue meet is called mucogingival junction. (Dr. Boehm)
One item that is checked for in dental exams (1), but not measured is the amount of gum tissue next to the teeth. The gum tissue next to teeth consists of two parts:
- Gingiva: the firm, rubbery, non-movable tissue typically next to teeth. This may be patchy black or brown for dark-skinned individuals. Without pigmentation, it has a uniform coral pink color when healthy.
- Mucosa: the usually darker, red-pink soft, delicate and flexible tissue that borders the gingiva and forms the inside surface of cheeks and lips. Pigmentation is very rare in this tissue and usually needs to be evaluated by a healthcare professional if present.
Dental practices usually do not record measurements of the relative amounts of these tissues since this usually is not meaningful to treatment. The exception is a lack of gingiva, which typically is noted as a finding in a chart entry. In this article, we explain some terms that may be used by a dentist discussing treatment and how issues with the amount of gingiva present affect your oral health.
What is measured here?
The amount of gingiva is checked during some dental exams, as shown above. The key is to identify where gingiva and mucosa meet at the anatomic landmark called “mucogingival junction”. The mucogingival junction usually is found in two ways:
- Visually: For most individuals, the mucogingival junction is visible as the line separating pink or pigmented gingiva from the red-pink mucosa.
- By a roll-test: If the color difference is not visible, a dental provider can find the mucogingival junction by gently pushing the mucosa towards the teeth with the side of a probe. The mucogingival junction is where the mucosa will start folding up on itself when pushed against the teeth as it cannot move further. Dental providers usually employ this test only when the gingiva cannot be identified visually since the roll test causes some minor discomfort.
In clinical research, the mucogingival junction can also be identified with staining solutions (i.e. Schiller’s iodine), but this is not used in common dental practice.
Dental providers checking the gums will usually estimate how much gingiva is present, from the edge of gingiva (‘gingival margin’) adjacent to teeth to the mucogingival junction. This is sometimes called ‘keratinized gingiva’. Dental providers will then take a mental note on the probing depths that were measured previously during the exam, and in their mind subtract the probing depth from the keratinized gingiva to obtain an estimate of the so-called ‘attached gingiva’:
Attached gingiva = Keratinized gingiva – Probing depth
Typically, there are only two meaningful conditions concerning the amount of gingiva:
- There is ‘attached gingiva’ present
- There is no ‘attached gingiva’ (the above mental math results in zero or some negative number; probing depth > keratinized gingiva)
If there is attached gingiva, there is no concern. No attached gingiva or a lack of attached gingiva may be a concern that needs to be addressed. If there is no attached gingiva, the affected area is said to have a ‘mucogingival defect’.
Tooth with no attached gingiva. The thin rim of pink gingiva at the tip of the probe is less than the probing depth at this tooth (Dr. Boehm)
How does presence of a mucogingival defect affect me?
Generally, teeth with mucogingival defects may be prone to developing receding gums (gingival recession). Dental implants that lack a band of gingiva around them may be more prone to developing disease and eventual loss of the implant (2).
Presence of mucogingival defects may be also a sign of a thin biotype, which is more prone to gingival recession (3).
How do mucogingival defects affect my treatment?
Dentists may recommend referral to a periodontist for gum grafting procedures for teeth with mucogingival defects. This is usually done to prevent gum recession and problems around implants and any other dental work (i.e. fillings, crowns, bridges, teeth supporting partial dentures).
When should I be concerned about mucogingival defects?
Teeth should be bordered by gingiva. If you notice any area where the tissue appears thin or it looks like the tooth has gotten longer, consult a dentist.
What conditions cause mucogingival defects?
The position of the mucogingival junction is determined by genetic factors (4). Mucogingival defects usually develop as result of:
- Gum recession (“gingival recession”)
- Gum disease, i.e. periodontitis.
- Abnormal tooth position
- Genetic conditions (i.e. cleft lip and palate)
About the author:
Tobias K. Boehm, DDS, PhD, MBA, PC, DABP, DICOI, FGDIA is the founder of The Dental Institute, executive director at The Defeating Epilepsy Foundation and a professor at Western University of Health Sciences where he teaches and practices a periodontal specialist.
References:
(1) American Academy of Periodontology on comprehensive periodontal evaluation. Comprehensive Periodontal Evaluation (CPE) – American Academy of Periodontology
(2) Chackartchi T, Romanos GE, Sculean A. Soft tissue-related complications and management around dental implants. Periodontol 2000. 2019 Oct;81(1):124-138. doi: 10.1111/prd.12287. PMID: 31407443.
(3) Cortellini P, Bissada NF. Mucogingival conditions in the natural dentition: Narrative review, case definitions, and diagnostic considerations. J Periodontol. 2018 Jun;89 Suppl 1:S204-S213. doi: 10.1002/JPER.16-0671. PMID: 29926948.
(4) Baghele ON, Bezalwar KV. A study to evaluate the prevalence of teeth without clinically detectable mucogingival junction. J Indian Soc Periodontol. 2022 Mar-Apr;26(2):162-168. doi: 10.4103/jisp.jisp_808_20. Epub 2022 Mar 1. PMID: 35321301; PMCID: PMC8936019.