title: Gingival bleeding on probing: relationship to change in periodontal pocket depth and effect of sodium hypochlorite oral rinse.
abstract: 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.
  
  
  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.
authors.affiliation: Graduate Periodontology Clinic, Ostrow School of Dentistry of USC, Los Angeles, CA, USA.
authors.forename: S
authors.initials: S
authors.lastname: Gonzalez
authors.forename: C L
authors.initials: CL
authors.lastname: Cohen
authors.forename: M
authors.initials: M
authors.lastname: Galván
authors.forename: F A
authors.initials: FA
authors.lastname: Alonaizan
authors.forename: S K
authors.initials: SK
authors.lastname: Rich
authors.forename: J
authors.initials: J
authors.lastname: Slots
mesh_terms: D000328:Adult; D000891:Anti-Infective Agents, Local / Q000008:administration & dosage / Q000627:therapeutic use*; D018450:Disease Progression; D005500:Follow-Up Studies; D005884:Gingival Hemorrhage / Q000188:drug therapy; D006801:Humans; D009067:Mouthwashes / Q000008:administration & dosage / Q000627:therapeutic use*; D010512:Periodontal Index; D010514:Periodontal Pocket / Q000188:drug therapy*; D010518:Periodontitis / Q000188:drug therapy; D016037:Single-Blind Method; D012973:Sodium Hypochlorite / Q000008:administration & dosage / Q000627:therapeutic use*; D016896:Treatment Outcome
chemical_list: D000891:Anti-Infective Agents, Local; D009067:Mouthwashes; D012973:Sodium Hypochlorite
keywords: dental plaque; gingival bleeding on probing; household bleach; mouthrinse; periodontal treatment; sodium hypochlorite