subgingivaal

Subgingivaal is a term used in dentistry to describe anything located beneath the gingiva (gums). In Dutch, subgingivaal refers to subgingival conditions, spaces, or materials around the teeth. The gingiva forms a seal around the teeth; the subgingival space includes the gingival sulcus in health and periodontal pockets in disease, extending to the cementum of the tooth root.

Anatomy and microbiology: The subgingival area lies below the gingival margin and may harbor surfaces not exposed to the mouth. It contains biofilm and calculus that accumulate beneath the gum line. The subgingival biofilm is largely anaerobic and includes periodontal pathogens such as Porphyromonas gingivalis, contributing to inflammation and tissue breakdown.

Clinical significance: Subgingival plaque and calculus are central to periodontal disease. With progression, pocket depth increases, attachment loss occurs, and bone support around teeth can be compromised. Diagnosis relies on periodontal probing to measure pocket depth and bleeding on probing, as well as assessment of attachment level; radiographs help evaluate bone loss.

Treatment and management: Non-surgical therapy targets the subgingival environment and includes scaling and root planing to remove subgingival calculus and biofilm, often with ultrasonic instrumentation. Adjuncts may include antiseptics such as chlorhexidine and locally delivered antibiotics. If pockets persist, surgical options such as flap procedures or regenerative techniques may be used. Long-term success depends on oral hygiene and regular maintenance.