Abstract
This is a case report of a patient in whom recovery of gingival recession was obtained with the use of a proper brushing technique, without any need for periodontal surgery. A 26-year-old female patient presented with the chief complaint of pain induced by cold water in the lower right posterior region of the mouth. Periodontal examination and x-ray revealed dental caries around the lower right molars. The pocket depth in the region of the right upper molars was 4.0 mm. Although the patient had gingival recession at 13, 14 and 23, and a festoon gingiva (McCall's festoon) was recognized, her occlusal style was group function and the occlusion was stable. Based on the periodontal disease classification proposed by the Japanese Society of Periodontology, this patient was diagnosed as having generalized mild chronic periodontitis with gingival recession of the anterior maxillary region. As a poor brushing technique was thought to be the cause of the gingival recession, the patient was given instructions on oral hygiene, especially focusing on a proper brushing technique, so as to achieve a satisfactory gingival condition and plaque control. After 15 years, the gingival recession gradually recovered on the side of the wedge-shaped defect. At 18 years after the first treatment, the creeping gingival attachment was found to totally cover the wedge-shaped defect. However, it was difficult to keep good condition of subgingival region by brushing, and the onset of gingivitis was recognized around the marginal gingiva. Brushing towards the apical region was advised for improving the gingival level on the side of the wedge-shaped defect. After 25 years, the gingival condition of the patient remains satisfactory and the oral environment healthy. This case report emphasizes that improper tooth brushing can cause gingival recession. With appropriate diagnosis, provision of instructions on the proper technique for brushing may be expected to yield successful and exceedingly predictable results in the treatment of gingival recession.
