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Overview :
The Gingival Bleeding Index is a measure of gingivitis as
indicated by bleeding following dental flossing. It can be used either for
initial patient evaluation or over time to assess response to interventions to
improve periodontal health.
Procedure:
(1) The mouth
is divided into 6 segments (upper right, upper anterior, upper left, lower
left, lower anterior, lower right).
(2) The
American dentition notation is used, with maxillary dentition numbered 1 to 16
going from right to left, and mandibular dentition going 17 to 32 from left to
right.
(3) Areas involving
the third molars are not scored because of variations in arch position, access
and vision.
(4) Unwaxed
dental floss is alternately passed interproximally into the gingival sulcus on
both sides of the interdental papillae. With the floss extended as far as
possible towards the buccal and lingual, the floss is carried to the bottom of
the sulcus. The floss is then moved in an inciso-gingival motion for one double
stroke. Care is taken not to cause laceration of the papillae.
(5) A new
length of clean floss is used for each interproximal unit.
(6) Bleeding is
generally immediately evident in the area or on the floss, but 30 seconds are
allowed for reinspection of each segment. If bleeding is copious, the patient
should rinse between segments.
(7) An area is
nonscoreable when tooth positions, diastemas or other factors compromise the
desirable interproximal relationships.
Bleeding assessment:
(1) no attempt is made to quantify the degree of bleeding
(2) bleeding is assessed only as present or absent
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Bleeding
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Coding
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absent
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<blank>
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present
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B
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not scoreable
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X
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Interproximal Areas of Maxillary Teeth
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Code
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Code
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Interproximal Areas of Mandibular Teeth
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2 - 3
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30 - 31
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3 - 4
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29 - 30
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4 - 5
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28 - 29
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5 - 6
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27 - 28
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6 - 7
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26 - 27
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7 - 8
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25 - 26
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8 - 9
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24 - 25
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9 - 10
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23 - 24
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10 - 11
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22 - 23
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11 - 12
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21 - 22
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12 - 13
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20 - 21
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13 - 14
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19 - 20
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14 - 15
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18 - 19
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total scoreable areas =
= 26 - (number of nonscoreable areas)
Gingival Bleeding Score =
= total bleeding areas =
= SUM(number of bleeding areas)
total nonbleeding areas =
= SUM(number of nonbleeding areas)
= (total scoreable areas) - (total bleeding areas)
Interpretation:
• The fewer the
number of bleeding sites, the less the extent of gingivitis. Ideally the score
should be 0.
• If the
patient is to be followed over time, previous bleeding sites are monitored to
see if they become nonbleeding. The goal of interventions is to reduce the
score as much as possible.
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