Can periodontal probing improve clinical variables in untreated periodontal patients? A case series

PURPOSE. To evaluate any variations in periodontal indices (dental plaque, bleeding on probing, gingival recession, pocket depths) after periodontal probing in untreated subjects suffering from periodontal disease. MATERIALS AND METHODS. This is a single centre case series. Fifteen participants in need of periodontal therapy were consecutively recruited. At baseline (T0), patients were assessed on a periodontal chart by an experienced periodontist. The following variables were evaluated: presence of plaque (Pl), pocket depth (PD), bleeding on probing (BoP), and gingival recession depth (Rec). The variables were recorded at both patient and tooth site level. After that, the patients waited for one hour in the waiting room, and then the same variables were recorded again (T1) by the same periodontist. The patients were discharged with no dental care instructions, motivation or therapy. After two weeks, the patients were recalled, and the same variables were recorded again (T2). Multilevel models were applied for inferential analysis at site level. RESULTS. All 15 patients completed the study. The difference between T0 and T1 was not significant for the variables PD (difference 0.00 mm; 95% CI from -0.02 to 0.02; P = 0.97) or Rec (difference -0.01 mm; 95% CI from -0.02 to 0.01; P = 0.39). However, the number of sites with presence of plaque decreased from T0 to T1 (OR = 0.59; 95% CI from 0.51 to 0.68; P<0.0001), while the number of sites with BoP increased from T0 to T1 (OR = 1.71; 95% CI from 1.45 to 1.96; P<0.0001). The difference in PD between T0 and T2 was significant (difference -0.15 mm; 95% CI from -0.18 to -0.12; P<0.0001), as was the difference in Rec (T0–T2 difference 0.03 mm; 95% CI from 0.01 to 0.05; P = 0.0006). The number of sites with plaque present did not change from T0 to T2 (OR = 1.00; 95% CI from 0.87 to 1.14; P = 0.98), but the number of sites with BoP decreased from T0 to T2 (OR = 0.68; 95% CI from 0.60 to 0.77; P<0.0001). CONCLUSIONS. Dental plaque, bleeding on probing, pocket depth, and gingival recession can change over time without any therapy. In particular, merely recording these variables (T0) can increase bleeding on probing and reduce plaque after one hour (T1). After two weeks (T2), a decrease in inflammation was noted, characterized by reduced bleeding on probing, a slight decrease in probing depth, and a slight increase in gingival recession.