Case-Control Study to Evaluate the Oral Hygiene Habits in 31 Children with Hemophilia in Bulgaria Using the Oral Health Impact Profile-14 (OHIP-14) Questionnaire

Abstract

Background For patients with hereditary coagulopathies such as hemophilia, the most common dental problem is spontaneous oral bleeding caused by daily oral hygiene habits like tooth brushing. Because of fear of bleeding, children with hemophilia often skip routine oral hygiene procedures, which can lead to dental caries and periodontal diseases. This case control study aimed to evaluate the oral hygiene awareness and hygiene practices of children with hemophilia from 6 to 18 years of age in Bulgaria. Material/Methods This study was conducted over 4 years and included 31 patients (children). A sociological approach was used, with direct individual questionnaires for self-assessment of dental habits. Statistical analyses were performed using SPSS. Results There was no significant difference between groups in methods of oral hygiene. The duration of oral hygiene procedures was 1 min (n=5, 16.13±6.61%) or 2 min (n=13, 41.94±8.86%), which was considered insufficient for proper oral hygiene. Children who had received oral hygiene advice by a dentist brushed their teeth significantly longer (n=9, 69.23±12.80%) than those who had not. There was a considerable difference between the reasons for the last dental visit between the groups of children (χ 2 =5.18, P <0.05). Conclusions Children with hemophilia have high awareness of oral hygiene methods; however, more attention should be focused on additional individual educational methods at the dental office. Frequent professional and self-assessment of the oral hygiene routine of children with hemophilia could identify the factors compromising dental status in this vulnerable population.

Oral health in individuals with bleeding disorders: A systematic review and meta‐analysis

“…Subsequently, the full texts of the 26 records were read and assessed. Finally, 22 articles were included in the final analysis 1–7,11–25 . Of the 22 articles assessed, nine quantitative assessments were included in the Meta analysis (Figure 1).…”

“…The databases Pubmed (56), Embase (164), Scopus (12) and additional sources (22) initially led to the identification of 254 records. Forty-five records were initially removed as they were found to be duplicates.…”

“…Finally, 22 articles were included in the final analysis. [1][2][3][4][5][6][7][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25] Of the 22 articles assessed, nine quantitative assessments were included in the Meta analysis (Figure 1).…”

“…They also reported that oral bleeding was the only significant factor in assessing the oral health-related quality of life in individuals with congenital bleeding disorders. Kumar et al 22 reported that almost half of the subjects had prolonged bleeding following exfoliation of deciduous teeth, out of which 22% sought medical help in hospitals for factor and plasma transfusions. This highlights the need for oral health promotion and awareness, particularly during the crucial stages of exfoliation and development, to prevent injury and bleeding in these individuals.…”

Complications following dental treatment in a child with haemophilia A: lessons to be learnt

“…Bleeding at the time of shedding of primary teeth may be the first sign of a child having haemophilia. These recurrent episodes may lead to parents avoiding brushing the teeth of haemophilia-affected children, for fear of gingival trauma leading to bleeding 3. This is a misunderstanding since gingivitis is a consequence of plaque deposits on the teeth.…”