Early gum disease known as gingivitis can advance to a more serious gum disease called periodontitis. The bacterial plaque can spread and grow below the gum margin as time pass, specially when bacterial plaque is not removed from teeth and gums. Gums become irritated when bacteria produces toxins. A chronic inflammatory response in which the body in essence turns on itself is stimulated by bacteria, and causes gum tissues and bone that support the teeth and gums to be broken down and destroyed. When gums already separate from the teeth, forming deep periodontal pockets is the time that periodontal surgery is needed to be able to restore dental health and eradicate infected teeth and gums to keep uninfected parts safe from infection.