Bleeding on Probing
When we are doing a re-assessment of periodontal conditions following an active phase of non-surgical periodontal therapy (i.e. supra/sub-gingival debridement), we probe a sulcus/pocket to evaluate the probing depth, but also the Bleeding on Probing (BoP).
…these are my tips…
1. If bleeding is noted after probing (BoP +), it means not only that the examined site is inflamed, but also that there is a 30% of probability that gingivitis is progressing into periodontitis.
Therefore…periodontal disease is not stable at that site!
Badersten A, Nilvéus R, Egelberg J. Scores of plaque, bleeding, suppuration and probing depth to predict probing attachment loss. 5 years of observation following nonsurgical periodontal therapy. J Clin Periodontol. 1990 Feb;17(2):102-7.
Claffey N1, Nylund K, Kiger R, Garrett S, Egelberg J. Diagnostic predictability of scores of plaque, bleeding, suppuration and probing depth for probing attachment loss. 3 1/2 years of observation following initial periodontal therapy. J Clin Periodontol. 1990 Feb;17(2):108-14.
2. If you are probing a pocket > 5 mm and there is no bleeding after probing (BoP –), there is a 98% of probability of absence of further clinical attachment loss.
Therefore…your pocket is not getting worse!
Lang NP1, Adler R, Joss A, Nyman S. Absence of bleeding on probing. An indicator of periodontal stability. J Clin Periodontol. 1990 Nov;17(10):714-21.
From the above 2 tips, you can realize how important is the assessment of bleeding on probing (and not only the pocket depth!) for your future clinical decisions and treatment planning.
Clinical Lecturer – Periodontology
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Arjun Varma – BDS 4