**6. Conclusion**

The successful prevention and treatment of gingival diseases will not only save the patient's teeth, but also prevent the dangerous consequences on the general health. Subsequently, this will pave the way to a premium physical and mental health along with better quality of life.

*Gingival Disease - A Professional Approach for Treatment and Prevention*

• Neoplasms, such as odontogenic tumors

of periodontitis

*attachments?*

**the systemic health**

represented in the pregnant [27].

hyperparathyroidism.

3.Systemic disturbances which can cause loss of periodontal tissues independent

• Other disorders that may affect the periodontal tissues. For example

*What is the impact of immune system disorders on the gingival and periodontal* 

diseases, optimize the treatment, and improve the quality of life as well [17].

A lot of research took place in order to answer this question:

*"To what extent might gingivitis affect systemic health?"*

**3.2 The second direction is to explain the impact of gingivitis or periodontitis on** 

Plaque-induced gingival disease is a chronic inflammatory process which causes elevation in the levels of serum inflammatory mediators, such as C-reactive protein CRP, TNF-alpha, IL-6, and IL-1B. Subsequently, the endothelial tissues might be affected by this elevation, which in turn will cause peripheral artery disease [19] and lead to a significant increase in cardiovascular illnesses [20]. This conclusion is found to be more prominent if the loss of periodontal attachment is more than 4 mm in at least 30% of six different sites in the oral cavity [21]. On the other hand, the proper treatment of periodontitis can improve endothelial function and may prevent the incidence of cardiovascular diseases [22] and other systemic disorders as well [23]. Interestingly, the same etiology of periodontitis, with high levels of pro-inflammatory serum mediators, will worsen the neurodegenerative diseases such as Alzheimer disease causing memory impairment and cognitive dysfunction [24]. Furthermore, the immune-inflammatory response toward periodontitis may initiate or exacerbate many systemic diseases including diabetes mellitus [15], osteoporosis, cancer [25], rheumatoid arthritis, and systemic lupus erythematosus [26]. In addition, pregnancy, which is the most delicate and important stage in a person's life, will be highly affected by any systemic disturbances or inflammation

It has been shown that many systemic disturbances can induce inflammation in the gingival tissue by affecting the host immune system, such as diabetes mellitus and obesity, through impairment of the immune defenses and elevating proinflammatory cytokines, which in turn will increase the risk of periodontitis and loss of periodontal attachment. Furthermore, there are many cytokines mediated in the immune response in the case of gingivitis or periodontitis, [17] and one of the most important and not well-studied mediator is the macrophage migration inhibitory factor MIF. The dentist after navigating the impact of systemic disturbances on the periodontium will definitely find that usual scaling and root planning is only a relief but not a cure in many cases. Therefore, it is mandatory to detect and uncover the systemic disorders which aggravate gingival inflammation in order to provide a comprehensive and definite treatment [18]. In addition, when the dentist investigates the gingival and periodontal diseases as the first manifestation of many systemic disorders, great numbers of serious illnesses will be early diagnosed. This will ultimately prevent the patient from any possible consequences of both oral and systemic

**8**

*Gingival Disease - A Professional Approach for Treatment and Prevention*
