Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse. (21st July 2014)

• Record Type: Journal Article
• Authors: Gonzalez, S.; Cohen, C. L.; Galván, M.; Alonaizan, F. A.; Rich, S. K.; Slots, J.
• Is Part Of: Journal of periodontal research. Volume 50:Number 3(2015:Jun.)
• Page Start: 397
• Page End: 402
• Publication Date: 2014-07-21
• Subjects: dental plaque -- gingival bleeding on probing -- household bleach -- mouthrinse -- periodontal treatment -- sodium hypochlorite; Periodontics -- Periodicals; 617.632
• DOI: 10.1111/jre.12219
• Languages: English
• ISSNs: 0022-3484

Abstract

Abstract : 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.