Recently, Skogedal et al.2 demonstrated that caries can be successfully prevented in patients with RDEB

by continuous follow-up aimed at dietary advice, oral hygiene habits, frequent professional cleaning, and fluoride therapy. 1)  To prevent and treat pain and infection. This is important considering that patients with oral pain will reduce their nutritional intake. The clinic must be of easy access for patients using wheelchairs and walking frames. Allow patients to accommodate on their own giving them enough time. Do not try to assist them if you are not aware of the areas where they have wounds. If the patient has to travel a long distance to attend the specialist dentist in the EB unit, a shared care Epacadostat approach can be arranged with a local dentist, who can provide more regular preventative care. Access to dental care can be a challenge for some patients. Even though in most developed countries it is guaranteed, it is still a privilege for many patients around the world. There is a lack of knowledge about the disease in the dental profession9 and other healthcare professionals. Dental care can be complicated by the fears of both the patient and the dentist10. Allow yourself plenty of time. Even the most simple procedures, such as an oral exam, takes longer because of the limited access, discomfort, or fear of developing blisters secondary to soft tissue manipulation. Members

of the multidisciplinary team should refer patients to the dentist before oral problems www.selleckchem.com/products/Vorinostat-saha.html present, as early referral and close follow-up are the key to keeping patients as healthy as possible from the oral point of view (Image 1). Patients with EB should be 2-hydroxyphytanoyl-CoA lyase referred to the dentist for the first consultation at the age of 3–6 months. The first consultation should be aimed at: (a)  Education of the parents and caregivers: counselling on diet (including sugar-free medications), oral hygiene routines, fluorides, technical aids, and oral manifestations of EB. This preventative advice should be provided even before the teeth erupt (Image 2). Patients with EB should be referred to a dentist as early

as possible to identify any feature related to EB that needs special attention, for example, generalized enamel hypoplasia5,10-13. This enables dentists to start preventive programmes and reduces the risk of developing dental diseases14. Many case reports have shown that patients visit the dentist only when they already have several carious lesions or pain7,11,15,16. Although oral bullae, ulcers, and erosions are the most common oral feature of EB, there is only one published study of a therapy for these oral lesions. Marini et al.17 found that sucralfate suspension reduced the development and duration of oral mucosal blisters and ulcers, reduced the associated oral pain, and improved plaque and gingival inflammation indices17. Oral Hygiene.