Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse
, , , , , Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse. J Periodont Res 2014; doi: 10.1111/jre.12219. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd
Background and Objective
This
study evaluated the potential of gingival bleeding on probing to serve
as a predictor of future periodontal breakdown. It also assessed the
ability of 0.25% sodium hypochlorite twice-a-week oral rinse to convert
periodontal pockets showing bleeding on probing to nonbleeding sites.
Material and Methods
The
study was performed as a randomized, single-blinded, clinical trial in
parallel groups. Seven periodontitis patients rinsed twice-weekly for
3 mo with 15 mL of a fresh solution of 0.25% sodium hypochlorite, and
five periodontitis patients rinsed with water. The 12 study patients
received no subgingival or supragingival scaling. Clorox®
Regular-Bleach was the source of sodium hypochlorite. At baseline and
3-mo visits, gingival bleeding was assessed within 30 s after probing to
full pocket depth using an approximate force of 0.75 N.
Results
A
total of 470 (38%) of 1230 periodontal pockets in the bleach-rinse
group revealed bleeding on probing at the initial visit but not at the
3-mo visit; only 71 (9%) of 828 pockets in the control group became
bleeding-negative during the study (p < 0.001).
Bleeding on probing in 4- to 7-mm-deep pockets decreased by 53% in the
bleach-rinse group but increased by 6% in the water-rinse group (p < 0.001).
Ninety-seven pockets showed depth increases of ≥ 2 mm after 3 mo: 60
(62%) of those pockets exhibited bleeding on probing at both the initial
and the 3-mo visits; 24 (25%) bled at only one of the two visits; and
13 (13%) never demonstrated gingival bleeding (p < 0.001).
Conclusions
Persistent
gingival bleeding on probing was associated with an increased risk for
periodontal breakdown, and the absence of gingival bleeding seemed to be
a useful, although not perfect, indicator of disease stability.
Twice-weekly oral rinsing with dilute bleach (0.25% sodium hypochlorite)
produced a significant reduction in bleeding on probing, even in deep
unscaled pockets. Sodium hypochlorite constitutes a valuable antiseptic
in periodontal self-care.
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