Comprehensive dental care and general anesthetic management of hereditary epidermolysis bullosa. A review of fourteen cases.

Dental management of persons with epidermolysis bullosa remains challenging because of the severe hard and soft tissue manifestations of these diseases. This study reviews the dental treatment of 14 cases requiring 24 general anesthetics. Twenty-three of the cases were managed with oral tracheal intubation to accomplish full-mouth dental rehabilitation. Dental therapy consisted of preventive, restorative, and surgical procedures, with extractions and stainless steel crowns being the most common treatment modalities. There were no serious postoperative complications, and no airway problems were experienced. Although extensive intraoral mucosal blistering did occur in several cases, postoperative healing progressed normally. Soft tissue trauma may be lessened through the use of small suction tips, flat tissue retractors, and extensive lubrication of all tissues requiring manipulation. This study provides further evidence that even the most severely affected patients with epidermolysis bullosa can receive comprehensive dental treatment directed at maintaining a functional dentition.