Sulcus bleeding index (SBI) and approximate plaque index (API) are tested at every appointment. The results are used to reflect the patient's progress of oral hygiene and overall progress. Typically SBI is performed first, and then API is performed secondly. This is because the gel of the API may stay on making it confusing to detect for bleeding.
Sulcus Bleeding Index (SBI)
1) Rinse to remove any food debris and dry the teeth.
2) Insert ball of WHO probe into the gingival sulcus at midline and sweep towards the interproximal until you reach the peak of the interdental papilla distally. However, do not sweep or count the inter proximal areas between central incisors or the 8s.
Quadrant 1 buccal: sit at 8 for posterior teeth and move towards 12 for anterior teeth
Quadrant 2 lingual: sit at 1 for posterior teeth and move towards 12 for anterior teeth
Quadrant 3 buccal: sit at 10 for posterior teeth and move towards 12 for anterior teeth
Quadrant 4 lingual: sit at 1 for posterior teeth and move towards 12 for anterior teeth.
3) Wait 10 – 20 seconds, observe the interproximal areas, record as + for bleeding and – for not bleeding. Measure the number of bleeding sites.
5) Calculate the percentage of bleeding sites over the total number of reading point.
One tooth missing: space open and restored by bridge = no change in reading points
One tooth missing: space closed by orthodontic treatment = -1 reading point
Two teeth missing: space still open - restored by bridge or partial denture = -1 reading point
Three teeth missing: space still open - restored by bridge or partial denture = -2 reading points
6) Make a comment on patient's overall oral hygiene.
Insufficient oral hygiene (>25%)
Good oral hygiene (less than or equal to 25%)
Very good oral hygiene (less than or equal to 15%)
Review Questions on SBI
How often do you perform SBI?
What does SBI stand for?
Where do you probe for SBI?
What are the steps of SBI?
What are you reading?
What does WHO stand for?
What are the surfaces you need to probe for SBI?
You have a tooth with 43, 44, 45 missing. Replaced 43 and 45 with 2 implants and placed a bridge i. Have you lost any reading points?
Same Scenario as above but done orthodontic treatment to close the gap. Then?
Apical Plaque Index
1) Rinse to remove any food debris and dry the teeth.
2) Micro-brush the disclosing agent called GC tricolour gel on the interproximal contact areas of teeth except between the central incisors.
Quadrant 1 lingual: sit at 1 for posterior teeth and move towards 12 for anterior teeth
Quadrant 2 buccal: sit at 1 for posterior teeth and move towards 12 for anterior teeth
Quadrant 3 lingual: sit at 10 for posterior teeth and move towards 12 for anterior teeth
Quadrant 4 lingual: sit at 1 for posterior teeth and move towards 12 for anterior teeth.
3) Rinse the tricolour gel and dry the area.
4) Record all blue stained tooth surfaces as positive reading points.
If unsure, use the WHO probe to attempt to remove any plaque from the contact areas.
Pink: Immature biofilm and less than 24 hours old
Dark blue: 48+ hours old plaque
Light blue: High risk, acidic biofilm with pH <4.5 at risk of caries and more than 72 hours old
4) Calculate the percentage of positive reading points.
5) Make an assessment on the overall oral hygiene
Insufficient oral hygiene (>35%)
Good oral hygiene (less than or equal to 35%)
Very good oral hygiene (less than or equal to 25%)
What does API stand for?
How often do you need to perform API?
What is the range for API ?
What do the colours of the tricolour gel mean?
Where do you apply the TC Tricolour gel?
What are the steps of API?
In patients with low SBI and high API, what might be some of the reasons?
Name another disclosing agent that can be used for API?
Why do you perform SBI first and API second
Px has API 25% but SBI 60-70%. Why?
Why do we wash before API?
Presentation of Results
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