Indices to Measure Gingival Bleeding

Abstract

Gingival bleeding is an objective, easily assessed sign of inflammation that is associated with several periodontal diseases. Many bleeding indices have been devised; some assess bleeding as simply present or absent, whereas others use grading in an attempt to assess severity of bleeding. The choice of which index to use depends on whether the purpose is an epidemiological survey, a clinical study, diagnosis and treatment, or patient motivation. Bleeding may be elicited manually with toothpicks, dental floss or a periodontal probe, but a controlled-force probe, although more expensive, causes less trauma and less false-positive bleeding from healthy tissues. As a predictor of periodontal disease progression, bleeding on probing has low sensitivity owing to a high frequency of false-positive responses, but has high specificity in that failure to bleed indicates health. There is evidence that smokers have less, or delayed, gingival bleeding when compared with non-smokers; therefore smoking needs to be controlled for in studies of gingival bleeding. Measurement of gingival bleeding tendency should be an integral part of a comprehensive oral examination. In clinical practice, the use of a graded bleeding index is more likely to identify sites that are at risk of further destructive activity. For monitoring individual patients, both for response to initial therapy and during maintenance, a modified Sulcus Bleeding Index (mSBI) with three bleeding scores is recommended in preference to dichotomous scoring of bleeding.

Gingivitis Susceptibility and its Relation to Periodontitis in Men

“…However, older men had higher amounts of plaque and calculus than younger men, which would not be consistent with a stronger association among younger men if due to residual confounding. Third, even when performed by a single examiner, clinical gingivitis measures have notoriously high variability (Newbrun, 1996;Van der Weijden et al, 1994). We would expect such measurement error to be non-differential and introduce bias toward the null, underestimating the true association between gingivitis susceptibility and periodontitis.…”

Dynamic among periodontal disease, stress, and adverse pregnancy outcomes

“…To score gingival bleeding for buccal and lingual surfaces, a Sulcus Bleeding Index (SBI) (15) and Bleeding on Probing (BOP) were assessed. (16). Periodontal examination was done by two dental clinicians.…”

Effects of a Novel Mouthwash on Plaque Presence and Gingival Health

“…Plaque levels (Turesky Modification of Quigley-Hein Index [23] (PI), gingival inflammation (Löe and Silness Gingival Index [22] (GI), and sulcus bleeding (mSBI) [24] were recorded before and after cessation of oral hygiene measures (please see below for details). Next, participants were randomized with regard to sequence of twice daily 1 min use of a test mouthwash, a control mouthwash and no mouthwash while abstaining from brushing the lower anterior teeth.…”