From Red Dots to Real Impact: Why Bleeding on Probing Matters

If you’ve ever found yourself midway through a perio charting thinking, “ I know this is important, but do I really need to capture something like bleeding on probing?” You’re not alone.

That’s a perfect time to reconnect as a team and revisit the benefits of a comprehensive periodontal assessment. Furthermore, reflecting on key questions  such as, is my perio assessment able to guide my dental hygiene diagnosis and a care plan that’s patient specific and targeting current disease activity? 

This is when we can uncover where infection persists, where health is maintained, and where disease may be quietly progressing.

Completing a comprehensive periodontal assessment isn’t just a clinical box to check, it’s a dedicated, patient-specific timeframe that allows for evaluation of disease activity, assess healing, and personalize care.

Comprehensive Records Protect You and Your Patients

Why it matters: Complete documentation benefits everyone, the patient, the practice, and the dental hygienist. It’s the only way to ensure true continuity of care.

We’ve all heard the common recommendation: annual periodontal assessments. But in reality, it is very dependent on the patient and your professional judgment. We know there are many cases when a closer timeframe between periodontal charting may be planned and truly beneficial to help support treatment planning. 

Incomplete perio charting or long periods of time between updates can blur the picture of changes and make it harder to engage patients in their care. When data is missing, our communication may be less confident and therefore can lead to less comfort in involving the patient as a partner.

Clear action: When data guides our care, decision fatigue drops. Clear and completed perio assessments help us make confident clinical judgments and share treatment options with precision and purpose.

Bleeding on Probing Is Critical

Why it matters: Bleeding isn’t just a red dot on a chart,  it’s the body signaling infection. Tracking bleeding over time provides a measurable picture of how well the patient is responding to therapy, hygiene intervals, and home care habits.

Clear action: By visualizing bleeding trends, and by creating a  “bleeding index” or score we make invisible disease visible. Patients engage more when they can see and understand infection. This visibility and clear understanding of their bleeding score sparks patient curiosity, accountability, and behaviour change in their oral health journey.

Assess First, Treat Second

Why it matters: We know not every dental hygiene visit will include completing a comprehensive perio assessment, but planning these updates based on the patient’s current oral health status adds clarity, structure, and value to the overall partnership between dental hygienist and patient. 

For patients who are due or have been flagged for an updated periodontal assessment, completing the assessment before beginning debridement and/or ultrasonic scaling is essential. Jumping straight into treatment intervention without current data means care isn’t being guided by an accurate picture of the patient’s current oral health.

Clear action: Starting with the “A” as per ADPIE, the assessment supports care that’s intentional, not routine. This builds trust and positions RDH's as a true partner, not just providing a "cleaning." This supports a focus on minimizing oral infection and reducing the inflammatory load that impacts oral–systemic health.

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Three Practices to Consider 

1. Regular Reflection

This is important at an individual level as well as a team.
Check in, pause and ask powerful questions, such as " What is one of the most important data points that will uncover current infection?"  Is my periodontal assessment comprehensive and complete ?
This simple mindset shift moves you to a place that prioritizes full data collection, including bleeding on probing. 

2. The Bleeding Score Moment

Share a summary with your patient: “You had 16 bleeding points today; our goal is to get this as close as possible to 0.”

These small, co-created goals help patients see progress and stay motivated.

3. Reflect & Record

After completing your periodontal assessments, take time to interpret findings and create a dental hygiene suggestion condition statement. Ask yourself is this patient in a state of disease remission or presenting in a state of active disease?
Over time, this process and clinical decision making gets clearer and guides your professional judgment.

Final Thoughts

Charting bleeding on probing isn’t negotiable, it's one of the most powerful indices.
It’s how infection is tracked, persistent inflammation is linked to further attachment loss, and the impact on systemic health is incorporated. It is also how we celebrate wins with healing, and ensures the care provided is making a difference in someone's life.
This is where the true value of dental hygienists shines, not just in what we do, but how we do it and the overall impact made with patient care.