Which habit most likely contributed to gingival recession in this patient?

• A. Using a hard toothbrush
• B. Not brushing at all
• C. Using a soft toothbrush
• D. Mouthrinsing with alcohol daily

Answer: (A)

Excessive abrasion from brushing with a hard toothbrush is the most likely cause of gingival recession. The stiff bristles and firm pressure can wear away the gingival tissue and the cementum at the tooth root, especially along the facial surfaces where the margin is more exposed. Over time this mechanical wear pulls the gum margin apically, exposing root surfaces and sometimes causing sensitivity. This is why a soft-bristled brush with gentle technique is recommended: it cleans effectively without eroding the gum line.

Not brushing at all would lead to plaque buildup and gingival inflammation, but it doesn’t explain recession from mechanical wear. Using a soft toothbrush is protective, and daily alcohol mouthrinses don’t cause recession through abrasion. Adopting proper technique—gentle pressure, a 45-degree angle to the gum line, and small horizontal or circular strokes—helps prevent further recession.