Definition and Correlation
- Bleeding on probing is the ulceration of sulcular epithelium.
- The blood comes from lamina propria after the ulceration of the lining.
- Bleeding on probing is correlated with Periodontal Inflamed Surface Area (PISA).
- X-rays for teeth and jaw bones can help determine periodontal health.
- The presence of bleeding on probing may not indicate periodontal disease, but the absence of bleeding is a strong predictor of continued periodontal health.
Diagnosis and Evaluation
- Dentists or dental hygienists use a periodontal probe or dental floss to assess sulcular depths and observe bleeding on probing.
- The Gingival bleeding index is used to measure gingivitis.
- The number of bleeding sites is used to calculate the gingival bleeding score.
- Bleeding on probing is a poor positive predictor of periodontal disease.
- Lack of bleeding is a very strong negative predictor of periodontal disease.
Treatment
- Corresponding treatments for diagnosed diseases should be prioritized.
- Regular visits to the dentist or hygienist for plaque removal are recommended every three months.
- Use a soft-bristle toothbrush for brushing teeth.
- Flossing twice a day can prevent plaque buildup.
- Avoid tobacco, as it can aggravate bleeding gums.
- Follow a balanced healthy diet.
- Consider using over-the-counter toothpaste with triclosan as part of a physiotherapy program.
- If inflammation and bleeding persist, a prescription of antiplaque rinse may be useful.
References
- CARRANZAS CLINICAL PERIODONTOLOGY, 9th edition, 2002. page 447
- Pietropaoli et al. (2020) Association between periodontal inflammation and hypertension using periodontal inflamed surface area and bleeding on probing. Journal of Clinical Periodontology, 47(2), 160-172.
- MedlinePlus: Bleeding gums
- Charles R. Craig, Robert E. Stitzel (2004) In Modern Pharmacology with clinical applications (Edition 6), Lippincott Williams & Wilkins, p. 506.
- Pietropaoli et al. (2020) Active gingival inflammation is linked to hypertension. Journal of Hypertension, 38(10), 2018-2027.
Additional Resources
- Howstuffworks: Bleeding gums
- Hayes, E. B., Gubler, D. J. (1992) Pediatr. Infect. Dis. J., 11, 311-317.
- Gingival Bleeding Index of Carter and Barnes
- Miller, P. D., Miller, W. D., Misch, C. E., Riggs, J. M., Seibert, J., Slots, J., Stillman, P. R., Tarnow, D. P. (Authors of CARRANZAS CLINICAL PERIODONTOLOGY)
- Mermaid Clinic: Gum disease and periodontal disease.
Bleeding on probing (BoP) which is also known as bleeding gums or gingival bleeding is a term used by dentists and dental hygienists when referring to bleeding that is induced by gentle manipulation of the tissue at the depth of the gingival sulcus, or interface between the gingiva and a tooth. BoP is a sign of periodontal inflammation and indicates some sort of destruction and erosion to the lining of the sulcus or the ulceration of sulcular epithelium. The blood comes from lamina propria after the ulceration of the lining. BoP seems to be correlated with Periodontal Inflamed Surface Area (PISA).
