Gingival Hemorrhage

Abstract: Background: The aim of this study was to assess the prevalence and extent of gingival recession, gingival bleeding, and dental calculus in United States adults, using data collected in the third National Health and Nutrition Examination Survey (NHANES III). Methods: The study group consisted of 9,689 persons 30 to 90 years of age obtained by a stratified, multi-stage probability sampling method in 1988 to 1994. The weighted sample is representative of U.S. adults 30 years or older and represents approximately 105.8 million civilian, non-institutionalized Americans. Gingival recession, gingival bleeding, and dental calculus were assessed at the mesio-buccal and mid-buccal surfaces in 2 randomly selected quadrants, one maxillary and one mandibular. Data analysis accounted for the complex sampling design used. Results: We estimate that 23.8 million persons have one or more tooth surfaces with ≥3 mm gingival recession; 53.2 million have gingival bleeding; 97.1 million have calculus; and 58.3 million have subg...

Abstract: Objective Clinical gingival inflammation is a well-defined site-specific condition for which several measurement systems have been proposed and validated, and epidemiological studies consistently indicate its high prevalence globally. However, it is clear that defining and grading a gingival inflammatory condition at a site level (i.e. a "gingivitis site") is completely different from defining and grading a "gingivitis case" (GC) (i.e. a patient affected by gingivitis), and that a "gingivitis site" does not necessarily mean a "GC". The purpose of the present review is to summarize the evidence on clinical, biochemical, microbiologic, genetic markers as well as symptoms associated with plaque-induced gingivitis and to propose a set of criteria to define GC. Importance A universally accepted case definition for gingivitis would provide the necessary information to enable oral health professionals to assess the effectiveness of their prevention strategies and treatment regimens; help set priorities for therapeutic actions/programs by health care providers; and undertake surveillance. Findings Based on available methods to assess gingival inflammation, GC could be simply, objectively and accurately identified and graded using bleeding on probing score (BOP%) CONCLUSIONS: A patient with intact periodontium would be diagnosed as a GC according to a BOP score ≥ 10%, further classified as localized (BOP score ≥ 10% and ≤30%) or generalized (BOP score > 30%). The proposed classification may also apply to patients with a reduced periodontium, where a GC would characterize a patient with attachment loss and BOP score ≥ 10%, but without BOP in any site probing ≥4 mm in depth.

Abstract: Gingival bleeding is an objective, easily assessed sign of inflammation that is associated with several periodontal diseases Many bleeding indices have been devised; some assess bleeding as simply present or absent, whereas others use grading in an attempt to assess severity of bleeding The choice of which index to use depends on whether the purpose is an epidemiological survey, a clinical study, diagnosis and treatment, or patient motivation Bleeding may be elicited manually with toothpicks, dental floss or a periodontal probe, but a controlled-force probe, although more expensive, causes less trauma and less false-positive bleeding from healthy tissues As a predictor of periodontal disease progression, bleeding on probing has low sensitivity owing to a high frequency of false-positive responses, but has high specificity in that failure to bleed indicates health There is evidence that smokers have less, or delayed, gingival bleeding when compared with non-smokers; therefore smoking needs to be controlled for in studies of gingival bleeding Measurement of gingival bleeding tendency should be an integral part of a comprehensive oral examination In clinical practice, the use of a graded bleeding index is more likely to identify sites that are at risk of further destructive activity For monitoring individual patients, both for response to initial therapy and during maintenance, a modified Sulcus Bleeding Index (mSBI) with three bleeding scores is recommended in preference to dichotomous scoring of bleeding