The October JADA "For the Dental Patient" feature, "Gingival Recession: Causes and Treatment" (
JADA 2007; 138[10]:1404[Free Full Text]
), is notably absent of the cause of the lesions presented in Figures A and B. One of the most notable causes of gingival recession is occlusal trauma caused by bruxism and/or clenching. While toothbrush abrasion potentiates the demineralization of the root surface, the tensile forces on the mineralized matrix of the root surface at the osseous crest are readily removed by abrasion and chemical agents. The patient is rarely aware of his or her condition, owing to its predominantly nocturnal nature.
I fully understand that the article is intended to prompt dialogue with patients. But, after having read this and being told that they may need further occlusal workup examinations, as well as possible splint therapy, equilibration or temporomandibular joint therapy, patients may be more than a little confused. These "gingival" lesions are not a periodontal phenomenon, and will return after grafting if the underlying disease is not treated. Many thanks on a generally fine publication.
