Gingival recession in relation to history of hard toothbrush use

Gingival recession studies in the U.S. have related primarily to sex and age with little consideration of toothbrush hardness. This preliminary study examined the relation between a history of hard toothbrush use and gingival recession. A total of 182 subjects, male and female, between 18 and 65 years of age, with a minimum of 18 natural teeth, no advanced periodontitis or history of periodontal surgery were examined. Gingival recession was scored as present whenever the free gingival margin was apical to the cemento-enamel junction and root surface was exposed. History of hard toothbrush use was ascertained. Eighty-two subjects had a history of hard toothbrush use, 77 did not, and 23 did not know. The percentage of subjects with recession increased with age from 43% to 81%, with a figure of 63% for all age groups combined. Males tended to show slightly greater levels of recession than females. Regression analysis showed that females had about 4 percentage points less receded surfaces than males. Recession was also found to be more pronounced for subjects with a history of hard toothbrush use, with a mean of 9.4% receded surfaces versus 4.7% for those who had never used a hard brush. For users of hard toothbrushes, the percent of surfaces with recession showed a significant and dramatic increase with increasing brushing frequency; this effect did not exist for those without a history of hard brush use. The relation with age was highly significant, with regression analysis showing that the percent of surfaces with recession tends to increase about 3.5 percentage points per decade.(ABSTRACT TRUNCATED AT 250 WORDS)