Higher Dental Caries Prevalence and Its Association with Dietary Habits and Physical Limitation in Epidermolysis Bullosa Patients: A Case Control Study

Abstract

Aim: Epidermolysis bullosa (EB) represents a highly rare subgroup of skin diseases that affects skin and mucous membrane. The aim of the present study was to assess caries prevalence and its associated factors in EB subjects. Salivary status was also assessed. Materials and methods:Ten subjects with EB who were under supervision were selected (cases) and matched by age and gender with unaffected individuals (controls). Dental caries were recorded using the World Health Organization (WHO) criteria. Oral hygiene and dietary habits were investigated by clinical examination and questionnaires. Both nonstimulated and stimulated saliva were collected and salivary pH, buffering capacity and mouth opening were evaluated. Results:The results showed that the median decay-missingfilled teeth was significantly higher (p = 0.0094) in EB cases 5 (3.9-20.3) than in controls 3 (2-3.25). The groups also differed when food consistency was analyzed. Individuals with EB have a higher intake of soft food. In addition, the median mouth-opening values from cases (0.84-2.84 cm) and controls (4.3-4.9 cm) have shown to be statistically different (p = 0.007). Considering the salivary parameters, none of them showed significant differences among groups. Higher Dental Caries Prevalence and Its Association with Dietary Habits and Physical Limitation in Epidermolysis Conclusion:Epidermolysis bullosa subjects present higher caries scores and might be related to their physical condition and dietary habits. Clinical significance:There is a lack of information about oral status in EB subjects. Hence, our findings add useful information regarding the relationship between caries prevalence and associated risk factors in EB subjects.

Epidermólise bolhosa – Uma série de 33 casos

“…Evidenciou -se uma série de comorbidades, sendo que o subtipo distrófico recessivo apresentou uma maior frequência e gravidade. Essas manifestações sistémicas são vastamente retratadas na literatura 3,6,8,10,11,20 e, dentre elas, ressalta -se o CEC. Quatro participantes apresentaram o CEC localizado em dorso de mão e em membros inferiores.…”

“…Resultados semelhantes foram encontrados na literatura. 8,11,12 Martinez -Serrano et al, 26 avaliaram 35 indivíduos com EBDR e as manifestações bucais também foram frequentes em 90% dos casos, como: lesões bolhosas, anquiloglossia, redução da profundidade do vestíbulo bucal e atrofia das papilas linguais. Além do mais, os pacientes com EBDR apresentaram lesões fibróticas, microstomia (grave/moderada) e atrofia das rugas palatinas.…”

“…6,9 Alterações nas estruturas da cavidade bucal são decorrentes do processo contínuo de formação de bolhas, ulceração e reparo com geração de cicatrizes e mília, resultando na perda das papilas linguais, anquiloglossia, ablação das rugas palatinas, obliteração do fundo de vestíbulo bucal, microstomia, CEC e aumento do índice de cárie. 8,[10][11][12] A EB não tem cura, o tratamento consiste em medidas paliativas para evitar a formação de bolhas, uso dos curativos antiaderentes, pomadas, analgesia, além do seguimento com a equipe multiprofissional. 12,13 Acerca da saúde bucal, é necessário o acompanhamento periódico no consultório odontológico, com a finalidade de prevenir, diagnosticar e tratar patologias bucais.…”

Az epidermolysis bullosa szájüregi tünetei és annak ellátása

“…Az EB-ben szenvedő betegek DMF-indexe szignifikánsan nagyobb, mint az egészséges embereké, aminek legfőbb oka a pépesebb, puhább étrend, illetve a korlátozott szájnyitás [22]. Fontos a fogazati torlódás, zománcdefektusok, incipiens cariesek korai felismerése a további laesiók kialakulásának elkerülése érdekében.…”

Correction of Nutritional Status in Complex Therapy for Children Suffering From Dystrophic Forms of Innate Epidermolysis Bullosa

“…У больных с ВБЭ это может быть связано со снижением аппетита, а также с отказом ребенка от пищи из-за затруднений с ее приемом (болезненность при жевании и глотании, затруднение глотания) [31,32]; 2) поражение зубов, которые ограничивают процесс откусывания и разжевывания и делают возможным употребление продуктов только жидкой консистенции [33][34][35]; 3) осложнения со стороны верхних отделов пищевари-тельного тракта полости рта, глотки, пищевода огра-ничивают прием пищи и нарушают переваривание питательных веществ; 4) повреждение слизистой оболочки ЖКТ и нарушение моторики, характерные для больных с ВБЭ, приводят к нарушению абсорбции и ретенции пищевых веществ; 5) каловые завалы, хронический запор и болезненная дефекация очень широко распространены среди больных с ВБЭ и часто вызывают апатию и вторичную анорексию; 6) повышенные потребности в нутриентах и энергии у этих больных связаны с потерей белка и минеральных веществ с отторгающимся эпидермисом и зависят от площади поражения кожи; 7) усиленный катаболизм на фоне хронического воспале-ния, открытые раны с сопутствующими им потерей кро-ви и серозной жидкости, потерей тепла и инфекциями увеличивают потребности организма в нутриентах.…”