Compulsive brushing in an adolescent patient: case report.

Gingival recession is common in many patients, and generally is associated with periodontal disease, inadequate toothbrushing, and repeated periodontal instrumentation, among other etiologies. Gingival recession as a consequence of regular toothbrushing has been reported, and can be observed even in young populations with well-established habits of oral hygiene. Gingival recession also is associated with selfinflicted injuries, whether intentional or not, using toothbrushes, toothpicks, fingernails and other materials that may produce acute, localized, or more extensive lesions." Localized lesions, termed "gingivitis artefacta minor," usually are due to some superimposed lesion or overzealous toothbrushing habits. Extensive lesions, also called "gingivitis artefacta major," are generally the result of compulsive behavior. These cases are found mostly among children with emotional disturbances, and deserve careful diagnosis and adequate treatment. This paper presents a case of severe gingival recession and periodontal destruction due to compulsive toothbrushing.