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BOP and gingivitis: It's time to draw a line in the sand

Jan. 25, 2017
In his “Making the Oral-Systemic Connection” blog on DentistryIQ, Dr. Richard Nagelberg explains why gingivitis needs to be a stopping point and why bleeding on probing is so important in turning patients around to better health.
When we probe a patient’s gums and they bleed—bleeding on probing (BOP)—that immediately means they have gingivitis. But why do they have gingivitis? The inflammatory response is ignited because there are too many bacteria in those sites. This results in the bleeding.

Do we have any treatments for gingivitis? Negatory … not at this time. How do patients get these bacteria in the first place? They missed a spot with their toothbrush, floss, or toothpick. The best gingivitis “treatments” we can offer for patients are instructions for meticulous home care and device recommendations, instead of just saying: “You need to brush more.”

We should consider gingivitis the line in the sand beyond which no patient will step. Failure to intervene at this point will result in some patients progressing to periodontitis, which is incurable and condemns one to a lifetime of disease management.

Do we know which patients will progress to periodontitis and which ones will not? Again, negatory. So, bleeding on probing is extremely important because it’s a wake-up call that gives the patient an opportunity to avoid a chronic, incurable disease that has effects far beyond the oral cavity. We just have to heed the sign and turn the patient around at this point to better health.


Richard H. Nagelberg, DDS, has practiced general dentistry in suburban Philadelphia for more than 30 years. He is a speaker, advisory board member, consultant, and key opinion leader for several dental companies and organizations. He lectures on a variety of topics centered on understanding the impact dental professionals have beyond the oral cavity. Contact Dr. Nagelberg at [email protected].

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