Kevin Anthony is your 10:00AM patient at the dental hygiene…

Kevin Anthony is your 10:00AM patient at the dental hygiene clinic at SPC. He is a 75 year old male. His vitals were as follows: BP 145/88 respiration: 17, Pulse 72. His last cleaning was 9 months ago. Kevin has a history of angina, atherosclerosis (with a heart stent placed in 2000), hypertension, rheumatic fever, and a stroke in 2005. He is allergic to penicillin. He takes lasix (diuretic), Procardia (heart medication) and vitamins daily. He is on a low sodium diet. He prevents with heavy supra and subgingival plaque, light subgingival calculus and no stain. His tissues are dark pink, marginal edema and they bleed upon instrumentation. What is the cause of his gingival inflammation and bleeding?