Incidence of gingival fissures associated with tooth brushing

This randomised crossover clinical trial evaluated 35 participants (aged 14-20 years) with periodontal attachment loss (PAL) ¿1 mm to compare the incidence of gingival fissures after using soft and medium toothbrushes. The experimental design was crossover with a 10-day interval between the two 28-day periods. Gingival fissures were assessed using a disclosing solution, and photographs were taken of selected quadrants every 2-3 days in 12 sessions. The photographic records were evaluated by a blinded examiner. Twenty-five per cent of participants had at least one gingival fissure. A high incidence of fissures was observed after using medium toothbrushes. In a multivariate model, the risk of developing fissures was 2 times higher with the use of medium toothbrushes compared to soft toothbrushes. The presence of vestibular PLA was associated with an increased risk of 5.19. Gingival fissures are a common finding associated with brushing. The use of medium-bristle toothbrushes, male gender, time, and previous PLA are significant risk factors for the incidence of gingival fissures.