Incorrect toothbrushing or using overly tough bristles can cause gingival recession and in turn it can create additional mechanical wear to the root surfaces of teeth. The root surface is softer than the top part of the tooth because it does not have outermost layer of enamel. It is covered by cementum which is softer than the enamel. Because it is softer, once the ginigva is receded, this cementum layer is more easily abraded by mechanical wear from excessive brushing force and/or from tough bristles on the toothbrush. Over time, the neck of the tooth will become notched, like this:
There are two ways to deal with this problem. One way is to have gingival graft. This requires surgery on the gingival tissue in order to harvest viable tissue to repair the gingival recession.
The second way is to put a composite filling on the defect. The result is like this:
Long time solution is to use correct brushing techniques, modify the brushing forces and also change to a soft toothbrush.
