Gingivitis is an inflammation or infection of the gums caused by the accumulation of tartar and plaque on the tissues of the mouth. It can be caused by injury to the gums, poor oral hygiene, misaligned teeth, hormonal changes (such as pregnancy or menstruation), or other diseases. The most obvious symptom of this disease is bleeding gums, but also produces sensitivity, red appearance, mouth sore, receding gums or bad breath. Treatment of gingivitis is a complete dental cleaning to reduce inflammation, which must be accompanied by proper brushing and flossing. If gingivitis is not treated properly it can lead to periodontitis, known as periodontal disease or pyorrhea which causes inflammation of the gums extends to the ligaments and bones that hold the teeth and, therefore, the teeth become loose or even fall. The treatment of periodontitis may include surgery to remove the gum infection and rebuild tooth brackets.