Gingivitis is a reversible inflammatory reaction of the gum. It is easily visible on examination and occurs in response to the accumulation of bacterial plaque. It is the most common form of periodontal disease (the tissue supporting the tooth) and occurs across all ages in individuals with teeth. If gingivitis is not treated, it may progress to periodontitis.
As is the case with natural teeth, the tissue surrounding dental implants can also be affected by bacterial plaque. In fact, these tissues, known as peri-implant tissues, have a lower response capacity against bacterial plaque aggression compared to periodontal tissues.
Periodontal and peri-implant diseases.
Gum diseases are caused by the accumulation of bacterial plaque, which is the main aetiological agent of these periodontal diseases (gingivitis and periodontitis) and peri-implant diseases (peri-implant mucositis and peri-implantitis).

Gingivitis
Generally observed:
-> Redness
-> Inflammation
-> Gingival bleeding
At a similar level is peri-implant mucositis, which is characterised by inflammation, redness and bleeding of the mucosa surrounding the implant.
### Periodontitis
Characterised by:
-> Redness
-> Inflammation
-> Bleeding
-> Other symptoms resulting from the destruction of periodontal tissue:
-> Gingival recession
-> Tooth mobility
-> Loss of alveolar bone supporting the teeth.
Likewise, peri-implantitis is characterised by inflammation, bleeding, mucosal recession, gum recession and loss of alveolar bone supporting implants.

Factors that contribute to the development of gingivitis (triggered by the presence of bacterial plaque):
- Local factors: poor oral hygiene, which favours the accumulation of bacterial plaque, tooth malpositions, occlusal trauma, overfilled restorations, fixed and removable orthodontics, and removable and fixed prostheses (bridges and crowns).
- Systemic factors: some cases of gingivitis are associated with the endocrine system. These include those associated with pregnancy, puberty, the menstrual cycle, and uncontrolled diabetes, among others.
- Medications: the use of certain medications can increase the risk of gingivitis.
- Malnutrition: at times, gingivitis can be associated with nutritional deficiencies.
Factors that contribute to the onset of periodontitis:
Smoking
Emotional or physical stress
Hormonal changes: puberty, pregnancy, menopause.
Medications: such as contraceptives and corticosteroids.
Acute infections and chronic diseases like diabetes.

Periodontal diseases can have consequences:
• Locally (in the mouth)
The most significant consequence is tooth loss, but it can also lead to gum bleeding, bad breath, recession, tooth mobility, and pain (though pain is not common)...
• Systemically (in the rest of the body)
The presence of a large number of bacteria beneath the gum line allows them to enter the bloodstream, either directly or through the systemic inflammation they cause, affecting other parts of the body and consequently increasing the risk of cardiovascular diseases, preterm birth, or diabetes decompensation.