Efficacy of tranexamic acid mouthwash as an alternative for factor replacement in gingival bleeding during dental scaling in cases of hemophilia: A randomized clinical trial

Abstract

Objective:The objective of the following study is to evaluate freshly prepared tranexamic acid mouth wash (FTAMW) as an alternative to factor replacement therapy (FRT) in controlling gingival bleeding in hemophiliacs during dental scaling.Materials and Methods:Experimental treatment regime (ETR) involved saline transfusion followed by FTAMW and the control treatment regime (CTR) involved FRT followed by placebo mouthwash. A total of 22 hemophiliacs randomly received dental scaling under either CTR or ETR at two different visits, following a split mouth design. They were instructed to use the rendered mouthwash 4 times a day for 5 days and record the mouthwash usage and bleeding episodes in a logbook. The difference in the bleeding episodes was analyzed using Chi-square test with the level of significance predetermined at 0.05.Results:Totally 19 patients completed the study. Seven patients reported no bleeding either in ETR or CTR; five patients noticed bleeding in CTR, but not in ETR. Three patients noticed bleeding in ETR, but not in CTR. Patients reported ease in usage and cost-effectiveness of ETR.Conclusion:FTAMW was found to be an effective alternative to FRT in controlling gingival hemorrhage in hemophiliacs during dental scaling.

Safety, Efficacy, and Cost-effectiveness of Tranexamic Acid in Orthopedic Surgery

“…It was initially introduced more than 40 years ago in cardiothoracic surgery and has shown application in controlling gynecologic hemorrhage and providing life-saving hemostasis in acute trauma. In addition to cardiothoracic 12 ; trauma 13 ; gynecological and obstetric 14,15 ; gastrointestinal 16 ; hepatic 12 ; urologic 17 ; and ear, nose, and throat surgeries, 12, 18 TXA has also been studied and used for diseases such as von Willebrand-factor deficiencies, 19 hemophilia, 20 and thrombocytopenia. 1,5,21 However, use in orthopedic surgery is not universal and remains subject to research.…”

Evaluation of a shortened course of tranexamic acid for patients with inherited bleeding disorders following dental procedures

“…An option for future hygienist procedures would be to provide the patient with TXA tablets but let them and the hygienist make a decision on whether or not it is required based on the amount of bleeding during and after the procedure. Two studies comparing the use of TXA with placebo during dental scaling in people with haemophilia reported that 38.5% and 36% of patients respectively did not bleed, regardless of whether TXA was given or a placebo [13,18] . The majority of patients in these studies had severe haemophilia, while the six patients interviewed for the current study all had mild bleeding disorders.…”

“…No conclusive evidence was found to advocate the efficacy of mouthwash compared with tablets, although TXA tablets are significantly cheaper than mouthwash [12] . Anderson et al suggest that tablets can be crushed by the patient and added to 10ml water to produce an oral solution that can be used as a mouthwash at a lower cost [10] , and the use of an oral solution prepared by patients using crushed tablets is reported by Nuvvula et al [13] . This method of administration is outside of Total: n=44…”

Niños con hemofilia y su atención odontológica por estomatología pediátrica. Revisión de la literatura / Children with Hemophilia and their Dental Care by Pediatric Stomatology. Review of Literature

“…De un total de 115 publicaciones, solo 29 artículos cumplieron con el criterio de inclusión. De estos, 15 se utilizaron para identificar lo más reciente y relevante con respecto al tratamiento estomatológico de niños con hemofilia A (4,6,7,9,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27). Ello incluye adecuada evidencia y guías de práctica (tabla 1).…”