Bleeding on Probing

Bleeding on probing is a term used by dental health professionals to refer to bleeding that occurs following gentle handling of the tissue between the gums and the teeth. Bleeding on probing is also referred to as bleeding gums or gingival bleeding and is a sign of inflammation of the periodontium. It also indicates possible damage to the gingival sulcus, which is the crevice located between the free gingiva and the crown of the teeth, or to the sulcular epithelium. The main cause of gingival bleeding is the accumulation of plaque that has built up at the gum line because of improper or inadequate oral hygiene, which includes regular brushing and flossing. Once this plaque has hardened, it becomes dental calculus, also known as tartar, and can only be removed with professional cleaning treatment. Other possible causes of gingival bleeding can include infection in the teeth or gums, diabetes, high blood pressure, malnutrition, hormonal imbalance, and some other illnesses or pathologies. Additionally, some medical therapies, such as anticoagulant or aspirin therapies, have been found to increase the risk of bleeding of the gums, as they increase blood flow in general.

A thorough dental examination and review of medical history can rule out more serious health issues; if disease is suspected, additional medical attention will be recommended for a proper diagnosis. During the dental examination, a dentist or hygienist will probe and record the depths of the gingival sulcus using a periodontal probe. A periodontal probe is a narrow metal cylinder that is marked on its sides with rings that are used to measure the depth of the gingival sulcus and periodontal pockets, in addition to determining the relative health of the gum tissue. Dental health professionals may also use dental floss to gauge the propensity toward bleeding of the gums, testing different areas of the gums to determine which areas are most prone to bleeding. As they are discovered, the number of areas that bleed upon probing are recorded, and this number is used to calculate a gingival bleeding score. While gingival bleeding is an inexact determiner of periodontal disease, the absence of bleeding is often an accurate indication of periodontal health. This means that bleeding may or may not indicate disease, but an absence of bleeding almost certainly indicates health of the periodontium, specifically of the gum tissue. Because the health of the gums is inextricably interrelated to the overall health of the periodontium, the presence of healthy gums is often a sign of an overall healthy mouth and healthy teeth.

The first step in treating gingival bleeding is diagnosing and addressing underlying diseases that may be contributing causes for bleeding. Once this has been addressed, gingival bleeding is addressed with improvements in oral hygiene, including proper brushing practices and daily flossing. It is recommended that patients who are prone to bleeding on probing avoid tobacco use, which is a known irritant of the gum tissue, and dental health professionals may also recommend dietary changes. Patients may also get a recommendation for a special over-the-counter toothpaste, or they may receive a prescription for an antiplaque rinse to address the underlying concern of deleterious plaque accumulation.