TY  - JOUR
AU  - Chalbi, Manel
AU  - Jrad, Rahma
AU  - Kachti, Soumaya
AU  - Chemli, Mohamed Ali
PY  - 2026
DA  - 2026/07/19
TI  - Dental Care in Children with Dystrophic Epidermolysis Bullosa: Case Report and Evidence-Based Management
JO  - OBM Genetics
SP  - 349
VL  - 10
IS  - 03
AB  - Epidermolysis bullosa (EB) is a group of rare, genetically determined disorders characterized by blister formation, skin fragility, and mucocutaneous blisters and erosions following minimal trauma. Oral manifestations and dental involvement of EB vary in frequency and severity depending on the subtype. Dental management of children with EB is complex due to the high risk of iatrogenic soft-tissue injury and requires strict adherence to evidence-based preventive and minimally invasive protocols. Published clinical practice guidelines recommend a trauma-free approach, reinforced preventive strategies, careful behavioral management, and modifications of dental instruments and procedures to minimize friction and pressure on oral tissues. However, detailed clinical implementation of these recommendations in complex pediatric cases remains limited in the literature. A 6-year-old girl with dystrophic epidermolysis bullosa and growth retardation was referred to the Pediatric Dentistry Department. Clinical examination revealed microstomia, multiple oral bullous lesions, gingival inflammation, ankyloglossia, enamel hypomineralization, and multiple carious lesions. Radiographic assessment was performed using panoramic imaging due to limited mouth opening. Dental management was carried out under local anesthesia only, using 2% lidocaine with epinephrine 1:80,000, without sedation or general anesthesia. Behavioral management included the Tell-Show-Do technique and progressive chair acclimatization. Protective measures were applied during all procedures, including lubrication of lips with petroleum jelly and minimal-pressure suction and air usage. Treatment included multiple staged extractions of severely decayed primary molars, atraumatic restorative treatment of permanent and primary teeth using hand excavation and glass ionomer cement, and preventive care consisting of oral hygiene instruction and dietary counseling. A customized toothbrush adapted to the patient’s hand deformity was also provided. The patient was followed over multiple visits with good tolerance and no major complications. This case reinforces that with strict adherence to minimally traumatic, evidence-based protocols, necessary dental treatment can be safely performed in children with dystrophic EB.
SN  - 2577-5790
UR  - https://doi.org/10.21926/obm.genet.2603349
DO  - 10.21926/obm.genet.2603349
ID  - Chalbi2026
ER  -