Periodontal probing: Stop when you see red
Gingival bleeding on probing indicates inflammation and requires treatment.
Jun 01, 2012
During oral assessment, treatment and prevention visits, a periodontal probe is used to evaluate gingival health while patients are anesthetized. Depending on an animal's size, the veterinarian or dental assistant checks each tooth, probing the subgingival pockets for abnormal depths. During probing, little attention is usually given to bleeding because it's accepted as a common occurrence.
Let's bring this same knee-jerk reaction to dogs' and cats' mouths. Gingival bleeding on probing indicates an inflammatory lesion both in the epithelium and in the connective tissue. Gingival inflammation leads to engorgement of the capillaries and thinning of the sulcular epithelium, predisposing capillaries to rupture from usually innocuous stimuli. Thus, bleeding during pocket-depth probing should elicit an immediate reaction to stop, diagnose and treat. Bleeding doesn't occur in healthy tissue unless abnormally traumatized by the probe.In simple terms, gingival bleeding is an objective, easily assessed sign of inflammation associated with periodontal diseases. Rare causes of gingival bleeding include hemophilia, leukemia, thrombocytopenia and liver and kidney disease. More commonly, though, bleeding comes from gingival inflammation due to inadequate plaque and tartar removal beneath the gum line.
Gingival bleeding assessment
Indices commonly used in human dentistry to assess gingival bleeding include the sulcus bleeding index, bleeding on probing and the gingival index.
Gingival index (GI) scores of 0 to 1 indicate nonbleeding sites, despite clinical assessment of marginal inflammation (GI score of 1). GI scores of 2 and 3 indicate that bleeding is found spontaneously or after stimulation of the gingival margin with a probe. Specifically, GI scores signify: