Identification of gingival recession can serve as a perfect example of how the hygienist

can make a difference. This condition is a seemingly minor problem that many simply
associate with esthetics. However, when patients have gingival recession with bleeding
pockets it could be an open source of infection. Patients can have a healthy mouth and
practice good oral hygiene and yet, still experience site specific areas of gingival
recession. Most are not even aware of it. Areas of recession can be caused by
toothbrush abrasion and trauma.3 All too often it is regarded as an unavoidable part of
the aging process.
In some patients, areas of recession are stable based on previously documented
measurements with no requirement for specific intervention or treatment. But with other
patients, we know otherwise. Recession can lead to the exposure of the tooth's root
surface, causing esthetic problems and sensitivity. Early diagnosis and treatment of
gingival recession is important because the situation can worsen to where predictable
root coverage isn't possible and esthetics become compromised.

Stable rec- The causes of gingival recession are not well understood, but are thought to be
associated with trauma or the loss of periodontal ligament attachment, or both, and are most
common at sites with inherently thin gingiva. However, the progressively thicker form of the
investing tissues more apically, coupled with the presence of underlying crestal bone, means that
recession tends to be selflimiting unless there is progressive periodontal ligament attachment
loss. (3,6) Consequently, progressive gingival recession indicates progressive alveolar bone loss
associated with active periodontal disease.

Longitudinal studies observing gingival recession rate of Gingival recession

quote studies
http://www.ncbi.nlm.nih.gov/pubmed/8126246
http://www.ncbi.nlm.nih.gov/pubmed/22092502
http://www.ncbi.nlm.nih.gov/pubmed/17397306

Methods- track movement of the free gingival margin with diagnostic photographs
and periodontal measurements at successive checkup, study models, CAL

Factors causing progression of gingival recession

unmodified or untreated etiologic factors eghttp://www.ncbi.nlm.nih.gov/pubmed/25495508
or due to various iatrogenic factors - ortho,prostho quote studies
Adequacy of attachd gingiva (hall) relate it to gingival recession
Decision making hall active vs stable
Management of active GR- removal of etiologic factors, preventive measures
including surgeries, patient maintenance