A Case Concerning the Oral Hygiene Management of a Child Patient Affected with Epidermolysis Bullosa

Abstract

Epidermolysis bullosa is a rare disease characterized by bullae or vesicles occurring on the skin or mucosal surface spontaneously or after a minor trauma. This disease is classified into four main groups and further into sixteen subgroups.
Recessive dystrophic epidermolysis bullosa causes contraction scars at the commissure of the mouth, so that tooth brushing becomes difficult, causing the teeth to become susceptable to severe dental caries. It is also difficult to undertake such dental treatment as pulp treatment of the molars and placement of space maintainers. Dental caries prevention is therefore having considered indispensable.
This patient was diagnosed as recessive dystrophic epidermolysis bullosa. The patient was given active oral hygiene management from the age of eight to seventeen.
The following findings were obtained:
1. Trismus was found and the buccal and labial vestibules were obliterated with scar tissue. It was therefore necessary to improve the form of the common tooth-brush obtainable on the market, which enabled the tooth-brush to be applied to the buccal surface of molar and did not aggravate intraoral bullae.
2. Since his dietary pattern was inclined toward soft foods, his caries susceptibility seemed to be higher. Therefore preventive methods such as temporary sealing of erupting molar by fluoridecontaining cement and fluoride mouth rinsing were performed additionally.
3. The oral hygiene condition was improved by the efforts of the patient and his family, so that no new caries have been found for nine years.