Inclusion Criteria:  ≥18 years old  Exclusion Criteria:  <18 years old Medical history that includes uncontrolled diabetes or hepatic or renal failure, or other serious medical conditions or transmittable diseases e.g. serious cardiovascular disease or AIDS. History of rheumatic fever, heart murmur, mitral valve prolapse, artificial heart valve or other conditions requiring prophylactic antibiotic coverage prior to invasive dental procedures. Antibiotic, anti-inflammatory or anticoagulant therapy during the 2 weeks preceding the baseline exam. History of alcohol or drug abuse. In treatment with medications causing gingival overgrowth Smoking ≥10 cigarettes a day Self-reported pregnancy or lactation (this criterion is due to oral tissue changes related to pregnancy and nursing which can affect interpretation of study results). Other severe acute or chronic medical or psychiatric condition or laboratory abnormality that may increase the risk associated with trial participation or investigational product administration or may interfere with the interpretation of trial results and, in the judgement of the investigator, would make the subject inappropriate for entry into this study.