Factitial (self-induced) gingival disease: four case reports.

Bizarre-appearing gingival recessions that do not correspond to any known gingival disease or oral manifestation of any known systemic disease are called factitial (self-induced) gingival disease. Psychological factors are very important in their etiology. Generally, the lesions occur during the time the child is experiencing stress associated with the frustration of his or her dependency needs. Four cases of self-induced gingival recessions involving children aged 4 to 6 years are presented and investigated from the pedodontic, periodontologic, and psychiatric viewpoints.