How does the periodontium work?

The periodontium keeps our teeth firmly in place in the mouth. It is made up of four parts:

  • Tooth sockets (dental )
  • Periodontal ligament
  • Cementum
  • Gums (gingiva)

The holes in the jaws that contain the roots of the teeth are called tooth sockets, or dental . The jaws and the walls of the tooth sockets are made up of bone tissue. This part of the periodontium is not usually visible.

Illustration: Periodontium - as described in the article

Periodontium

The teeth are connected with the walls of the tooth sockets and anchored in the jaws by the periodontal ligament and the cementum. The ligament is made up of connective tissue and contains fibers. These fibers are especially strong so that the teeth can withstand the great pressure put on them while we chew. The teeth can also move slightly in the ligament to compensate for the pressure exerted by chewing. In contrast, dental implants are firmly attached to the jawbone and are not able to move. In addition to connective tissue and fibers, the ligament contains blood vessels and nerves: the blood vessels supply the ligament with nutrients, while the nerves are responsible for controlling the amount of force used while chewing.

The actual tooth has an outer layer of cementum around its root. The cementum is mostly made up of minerals, but also contains fibers. It is very tightly connected to the ligament, binding the root of the tooth to the rest of the periodontium. The outer layer of the tooth gradually changes from cementum to dental enamel near the neck of the tooth.

The gums (gingiva) cover and protect the ligament and the neck of the tooth, and are usually the only visible part of the periodontium. The gums fit tightly around the teeth like a collar. They turn slightly inward where they meet the teeth, forming a narrow groove.

The gum tissue can easily become inflamed, causing it to slightly detach from the neck of the tooth. The groove between the tooth and the gum can then deepen to form what is referred to as a pocket. Bacteria rapidly build up in these pockets. Inflammation of the gums () can be visible as bleeding gums, but often does not cause any symptoms. Sometimes can lead to , an of the periodontium that attacks the gums as well as the bone of the jaw. Advanced can cause teeth to become loose and fall out, or require them to be removed.

Lippert H. Lehrbuch Anatomie. München: Urban und Fischer; 2017.

Pschyrembel. Klinisches Wörterbuch. Berlin: De Gruyter; 2017.

IQWiG health information is written with the aim of helping people understand the advantages and disadvantages of the main treatment options and health care services.

Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. informedhealth.org can provide support for talks with doctors and other medical professionals, but cannot replace them. We do not offer individual consultations.

Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.

Comment on this page

What would you like to share with us?

We welcome any feedback and ideas. We will review, but not publish, your ratings and comments. Your information will of course be treated confidentially. Fields marked with an asterisk (*) are required fields.

Please note that we do not provide individual advice on matters of health. You can read about where to find help and support in Germany in our information “How can I find self-help groups and information centers?

Updated on December 27, 2017
Next planned update: 2021

Authors/Publishers:

Institute for Quality and Efficiency in Health Care (IQWiG, Germany)

How we keep you informed

Follow us on Twitter or subscribe to our newsletter or newsfeed. You can find all of our films online on YouTube.