The work is to be 6 pages with three to five sources, with in-text citations and a reference page. Receding gums may occur with or without concomitant disease, and it has raised both medical and aesthetic concerns in patients and health care givers (Rossi, Pilloni, & Morales, 2009). Receding gum clinical manifestation takes on many forms depending on the causative factor, however, increased root sensitivity, cervical caries and cervical abrasions are typical examples. The widely adopted diagnosis and classification of gingival recession is the Miller’s classification. In this classification, the condition is graded in several classes that correlate with the severity and clinical presentation. In class one. for example, the recession depth does not reach the mucogingival junction, whereas, in class two, it extends beyond this junction. Class three is the advancement of class two with the involvement of the interproximal clinical attachment or rotation of the affected tooth. Lastly class four recession is the most severe form with extensive damage beyond class three. However, this classification is not inclusive of all cases, and several other classification strategies are also in use. A standing example of alternative classification is the Kumar & Masamatti’s classification, which is more detailed than Miller’s classification. It is also informative and devoid of limitations seen in the later strategy. There are a number of etiologies that lead to recession some of which are pathological in nature and others are not. Pathological etiologies include. recurrent inflammation, self inflicted trauma, and chemical erosion around teeth can lead to recession. On the other hand, mal-positioned teeth, shallow vestibule, inadequate keratinized attached gingival around teeth are non pathological predisposing factors. Other causes include surgical implants associated with any of the above conditions and other factors such as latrogenic factors, thin gingival biotype among others. An example of a surgical procedure as a risk factor to recession is apical surgery. This surgery is normally undertaken to seal an endodontically treated tooth (Von Arx, Alsaeed, & Salvi, 2011). Apical surgery influences the risk for gum recession by the degree of healing achieved as well as the type of incision made during the procedure. The success of peri-apical surgery, which has a low risk to recession, is influenced by other factors such as patient’s satisfaction, age, sex and smoking habits, which act as indirect risk factors for gum recession. (Von Arx, Alsaeed, & Salvi, 2011). It is interesting to note that tongue piercings as an aesthetic treatment is also associated with gingival recession. According to a study conducted by Pires, Cota, and Oliviera, et al, (2010) in Brazil among middle aged adults, individuals with tongue jewelry had a higher frequency of gingival recession than the control group. This risk factor is strongly associated with the trauma involved in the process of placing the jewelry. Apart from recession, tongue piercing significantly increases the risk for tooth fracture, especially the anterior teeth (Pires, Cota, & Oliviera, et al, 2010). Diagnosis of recession is by periodontal examination and subsequent classification of its severity. Demonstration of typical symptoms of gingival recession is the guarding factor in the diagnosis of the condition. Examples of highly indicative signs include.
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