• It starts as "Gingivitis" *
  (inflammation of the gums)
• It can be localized or effects the entire mouth depending on how the patient cleans his/her gums.
• Gingivitis is totally reversible and good brushing and flossing will clear it up in a few days.
• Hardly any discomfort is felt.  Gum disease can easily be ignored
• Smoking masks the bleeding, because it reduces blood flow in the smaller veins.
  
  Inflammation*:   Red, slightly swollen gums that bleed easily when touched. It is a local reaction to plague, not an infection. 

Ignoring the symptoms of gingivitis may lead to the spreading of this infection to the deeper layers of the BONE and TOOTH ATTACHING FIBERS.  Once the infection has progressed to this level and the BONE itself is infected, it is called Periodontitis ("-itis" means inflammation). There is NO Permanent CURE for this disease.

Initially there are no symptoms, because gum disease  happens very slowly and the patient is unaware of it.  The teeth become mobile and appear longer as the gum recedes (falsely identified as part of the aging process -"getting long in the tooth").  A terrible smell is present in severe cases, called Halitosis, but the patient is unaware of this, because of the slow-developing nature of this disease.

• People who are diabetic have an increase risk.
• Smoking is one of the greatest risk factors due to the negative effect on the blood vessels in the gum.
• Incorrect brushing (too hard / poor brush quality and the wrong brushing technique)
• Teeth grinding / bruxism
• Position of the teeth in the bone (skew teeth collects more plaque and are much more difficult to keep clean.)
• Genetic component (Often history of parents with gum disease) 

• Stroke risk x 2 times                                            
• Chronic Respiratory Disease x 2-5 times                     
• Coronary Artery Disease x 2 times                          
• Adverse Pregnancy Outcomes x 4-7 times
• Diabetes x 2-4  times