PREVENTIVE ORAL HEALTH CARE FOR PATIENTS WITH EPIDERMOLYSIS BULLOSA: AN INTEGRATIVE REVIEW

Abstract

Introduction: Epidermolysis Bullosa (EB) is a hereditary disease that causes skin fragility and blistering in response to trauma or friction, potentially affecting mucous membranes such as the mouth, tongue, gums, esophagus, and other internal surfaces. Several subtypes of epidermolysis bullosa exist, including the simplex and dystrophic forms, differing in severity and clinical manifestations. Oral manifestations may include lesions in the oral cavity, anodontia, and various dental anomalies. Patients frequently present with complications such as malocclusion and difficulties in dental care due to the extreme fragility of the mucosa. Objective: The objective of this study was to review the literature on strategies for preventing dental caries and periodontal diseases in individuals with Epidermolysis Bullosa, highlighting appropriate oral hygiene strategies and measures that minimize the need for invasive interventions. Methods: This study is an integrative literature review, conducted using the PICO strategy, formulated with the question: "In people with Epidermolysis Bullosa, does the adoption of adapted preventive oral hygiene measures contribute to reducing the incidence of caries, periodontal diseases, and the need for invasive treatments?". The search was performed in the PubMed, BVS, Scopus, SciELO, and LILACS databases, in Portuguese, English, and Spanish, covering the period from 2019 to 2025. DeCS descriptors were used, combined with the Boolean operator AND. Original studies addressing the proposed theme were included, and incomplete texts, literature reviews, and publications outside the period or in other languages ​​were excluded. Results: The nine studies included in this review showed that patients with Epidermolysis Bullosa have a significantly elevated risk for caries and periodontal diseases, due to clinical characteristics such as microstomia, ankyloglossia, enamel hypoplasia, and continuous formation of blisters and ulcerations in the oral mucosa. Evidence indicates that adapted preventive measures—such as the use of ultra-soft toothbrushes, non-traumatic hygiene techniques, rigorous biofilm control, frequent fluoride applications, photobiomodulation, and dietary guidance—are effective in reducing pain, improving oral hygiene, and slowing the progression of carious lesions. Studies also highlight the importance of periodic dental follow-up and the active involvement of the family in daily care. Conclusions: It is concluded that prevention is the central pillar of dental care in individuals with Epidermolysis Bullosa, being essential to minimize the development of caries, reduce periodontal inflammation, and avoid invasive treatments. The adoption of adapted oral hygiene protocols, combined with continuous monitoring by the dentist, significantly contributes to the maintenance of oral health and the improvement of quality of life. Therefore, the need for individualized preventive strategies and a multidisciplinary approach in the management of these patients is reinforced.