A Multidisciplinary Approach to the Management of Unusual Bilateral Gingival Recession Due to a Factitious Nail-Scratching Habit: A Case Report.

Self-inflicted gingival injuries have been reported in children and adolescents as a result of multiple factors such as accidental trauma, fingernail biting, sucking on objects such as pencils, or a nail-scratching habit. Management of these lesions requires a multidisciplinary approach that includes psychotherapy, behavioral counseling, and definitive treatment of oral soft tissue lesions. This paper illustrates the diagnosis and treatment of a 16-year-old male patient with a bilateral gingival recession in mandibular canines due to habitual nail scratching. A multidisciplinary approach for treatment included behavior and psychological counseling, topical application of anesthetic & antimicrobial gels, and surgical management of gingival recession defects using a modified lateral pedicle flap with and without an indigenously prepared amnion-chorion membrane. Excellent soft tissue health was found at a two-year follow-up.