Final answer:
Inadequate attached gingiva can be caused by several factors, such as poor dental hygiene leading to bacterial overgrowth, microbial infections progressing from gingivitis to periodontitis, and systemic conditions like nutritional deficiencies affecting collagen production.
Step-by-step explanation:
Factors that may contribute to inadequate attached gingiva, which is the part of the gum tissue firmly bound to the underlying bone, involve a range of oral health issues. Poor dental hygiene often leads to the overgrowth of oral bacteria such as Streptococcus spp. and Actinomyces spp., causing conditions like dental caries, tartar, and gingivitis.
Gingivitis, characterized by inflammation, redness, and irritation of the gums, can progress to periodontitis with the recession of gums and exposure of tooth parts. Various microbes, including Porphyromonas, Streptococcus, Actinomyces, Prevotella intermedia, Fusobacterium species, and Treponema vicentii can enhance disease progression and lead to more severe conditions. In addition, viral infections like herpes simplex virus type 1 can cause herpetic gingivostomatitis, which also complicates oral health. Other systemic factors such as nutritional deficiencies, like vitamin C deficiency leading to scurvy that inhibits collagen production, may also negatively impact periodontal health and contribute to the degradation of periodontal ligaments and tooth loss.