Tooth and gingival abrasion are defined as pathologic wear as a result of a foreign substance (Figure 12). Abrasion is multi-factorial but is generally believed to be caused by improper brushing technique, frequent brushing with too much pressure, bristle design or stiffness, dominant hand dexterity, or abrasiveness of toothpastes.4
Gingival recession is defined as the reduction of the height of the marginal gingiva to a location apical to the cementoenamel junction, resulting in root surface exposure (Figure 13). Gingival recession can also be precipitated by many factors including increasing age, gender, and anatomical factors. Improper occlusal load from the force generated by clenching and grinding the teeth may contribute to recession as can erosive wear.44 However, toothbrushing technique, frequency, duration, force of brushing, and the hardness of toothbrush filaments may also contribute to gingival recession.45 Therefore, studies have been conducted to address the safety of a power toothbrush compared with using a manual brush.