DENTISTRY Periodontal disease caused by hair is graded in stages: Stage 1 (PD 1): Gingivitis only; no attachment loss. The height and architecture of the alveolar margin are normal. Treatment includes ultrasonic dental scaling, polishing, irri- gation and hair removal. Stage 2 (PD 2): Early periodontitis; less than 25 percent of attachment loss or, at most, there is a stage 1 furcation involvement in multirooted teeth. In addition to hair re- moval, treatment can include root planing inserting local antimicrobials, such as Clindoral (TriLogic Pharma) or Dox- irobe Gel (Zoetis), subgingivally where pockets are present. Stage 3 (PD 3): Moderate periodontitis; 25 to 50 percent attachment loss as measured by either probing the clinical attachment level or by radiographic determination of the distance of the alveolar margin from the cementoenamel junction relative to the length of the root. Or, there is a stage 2 furcation involvement in multirooted teeth. Treat- ment includes hair removal, root planing, the possible in- sertion of local antimicrobials subgingivally where pockets are present and owner commitment to twice daily plaque control. Extraction is also a possibility (Figures 7A and 7B). Stage 4 (PD 4): Advanced periodontitis; more than 50 per- cent of attachment loss as measured by either probing the clinical attachment level or by radiographic determination of the distance of the alveolar margin from the cementoe- namel junction relative to the length of the root. Or, there is a stage 3 furcation involvement in multirooted teeth. Treatment includes hair removal and extraction (Figures 8A-8D and 9A-9F). Figure 8A. Advanced periodontal disease affecting the first and sec- ond incisors secondary to inflammatory response to embedded hair. Figure 8B. A mucogingival flap raised to extract the maxillary right and left first and second incisors. Figure 7A. A 6-mm periodontal pocket affecting the right maxillary first incisor secondary to embedded hair (same patient imaged in Figure 4). Figure 8C. Flap closure. Figure 7B. After extraction of the maxillary incisor and third premo- lars. Issue 03 | JUNE 2017 | 36 Figure 8D. The healing incisor surgical sites.