Periodontics · patient case question
The recession on #23 is caused by:
Patient case: Generalised bleeding on probing with an isolated 8 mm CAL loss on #23
Scenario: Bleeding on probing in 80-90% of the mouth, probing depths 2-3 mm throughout, EXCEPT tooth #23 which has 8 mm of CAL loss on the LABIAL ONLY. Photograph shows a patient who has lost no teeth, with healthy pink gingiva except at #23, where the root is almost fully exposed on the labial surface only.
Show answer and explanation
Correct answer: B. Mechanical abrasion from traumatic toothbrushing
- A. Occlusal trauma widens the periodontal ligament space and increases mobility; it does not by itself cause gingival recession.
- B. Correct. Isolated recession on the LABIAL surface of a prominent canine, in a mouth that is otherwise periodontally healthy with no tooth loss, is the signature of MECHANICAL ABRASION — aggressive horizontal brushing with a hard brush. The canine's prominent root position and thin overlying buccal plate make it the most commonly affected tooth.
- C. Orthodontic movement can cause recession by moving a root through the buccal plate, but the case gives no orthodontic history.
- D. Plaque-induced attachment loss produces INTERPROXIMAL bone loss and pocketing across multiple teeth, not an isolated labial defect with normal probing depths.
Note: Other contributors worth listing: thin gingival biotype, prominent roots and dehiscences, high frenal attachment, and lip or tongue piercings.