The periodontium is composed of gingiva, periodontal ligament, cementum and alveolar bone. The periodontium is responsible for supporting, protecting and nourishing teeth. The tissue components that comprise the periodontium are interdependent, and the health of all components are necessary for teeth to be periodontally healthy. Gingiva is the part of periodontium that is visible in the mouth and changes in consistency, color, quantity and quality can be able to signal potential problems or disease affecting the periodontium. The gingival complex is comprised of free gingiva, attached gingiva, gingival margin and gingival sulcus. The free gingiva is a mobile cuff of tissue above the alveolar crest, while attached gingiva is between 1-9m and extends to the muco-gingival junction and is bound by collagen fibers to bone and underlying cementum. The goal of this course is to review impact of conditions that impact gingival tissue such as bacterial plaque, gingival tissue profile, presence of recession, changes in anatomy such as altered passive eruption, gingival hyperplasia, biologic width and systemic conditions like diabetes have on overall periodontal health and review therapy to correct their impact and improve periodontal health.