Sometimes, the often harmless toothbrush may also cause us some discomfort in the form of injuries. Toothbrush injuries are caused by chronic physical irritation from the toothbrush bristles to the marginal and attached gingival.
Although any area of the entire dental arch can be involved, these lesions are more seen in maxillary gingival over the premolar and canine region (since these are the locations where maximum pressure is exerted during brushing). Moreover, lesions can develop more frequently on left sided gingiva if the patient is right handed or vice versa.
Clinical Features:
- The lesions commonly appear as superficial linear erosions
- Some lesions might appear as white, red or ulcerated areas.
- Most lesions produce pain, especially during taking food and some of them can be infected secondarily.
- When the injury is very severe, it can produce deep clefts on the gingival margin with severe gingival recession.
- In long standing cases, there may be irreversible loss of the underlying alveolar bone in the gingival.
Histopathology:
- The traumatic lesion of the gingival histologically shows ulceration with focal loss of overlying epithelium.
- The adjacent normal epithelium at the border of the ulcer exhibits hyper-parateratosis and acanthosis.
- The ulcerated area is covered by a superficial zone of granulation tissue.
- The underlying connective tissue shows chronic inflammatory cell infiltration by lymphocytes and plasma cells.
Treatment:
Elimination of local factors causing injury (development of proper brushing habit) and symptomatic treatment of the injured area by specialist is the best way to treat toothbrush injuries.
