Gingival recession is commonly associated with plaque‑induced inflammation and calculus. A high frenal attachment is more important in gingival recession in the child‑patient. A healthy child‑patient with impeccable oral hygiene presented with localized gingival recession without plaque‑induced inflammation which led to the exploration of other possible etiologies. Multiple factors appeared to be acting in consonance (Concomitant multiple etiologies [CME]). The factors were a high frenal attachment, traumatic overbite and bruxism induced by premature tooth contacts. Pedodontists and periodontists should rule out CME in cases of gingival recession in the child‑patient.
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