Dental considerations in a patient with haemophilia

Abstract

Haemophilia is a rare blood clotting disorder, characteristic features of which include extemporaneous and post-traumatic subcutaneous bleeding and mucosal haemorrhages. Genetic deficiency of coagulation factor VIII results in haemophilia A, while deficiency of factor IX leads to haemophilia B. The most common treatment for haemophilia A is administration of recombinant or plasma-derived factor VIII concentrate, to raise the levels of the deficient factor VIII. Tranexamic acid is also used as an anti-fibrinolytic agent that inhibits plasminogen activators present in oral secretion and stabilises the clot. Administration of factor IX is required in haemophilia B. Treatment leads to increased longevity and quality of life for patients. Dental conditions and treatments are more complicated and uncertain in patients with haemophilia due to bleeding risk, thus restorative dental care is of paramount importance for those with haemophilia. The fear of bleeding during treatment procedures is the primary cause of lack of proper dental care for people with haemophilia in countries with limited health care resources. This case report highlights the significance of clinical examination and investigation, and the importance of proper interaction between a haematologist and the periodontist for correct multidisciplinary and uneventful management of periodontal health of a patient with haemophilia.

Use of Erbium Laser in the Treatment of a Patient with Acute Purulent Periostitis and a Resistant Form of Primary Immune Thrombocytopenia

“…Cutting the tissue, the laser beam simultaneously coagulates the vessels on the wound walls, promoting hemostasis. In addition, postoperative edema is minimal and the intensity of the intraoperative and postoperative pain syndrome decreases [4, 10]. Laser radiation has a bactericidal effect on the pathological microflora in the operative zone, stimulates metabolism and tissue regeneration, and the increases the oxygen content in tissues, accelerating their early formation and preventing the formation of coarse postoperative scars [5, 10].…”

“…The complexity of the situation in these patients is due to an opportunity to treat only postoperative complications but not their preventive procedures. There are different data in special literature about the methods of solving the problem of bleeding after dental manipulation: tranexamic acid, extract of green tea, and others [4, 5].…”

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

“…Dental procedures are the most common invasive procedures performed on this population [2] . Close collaboration between patients, dental surgeons and haemophilia specialists is essential to reduce risk of bleeding complications [3] .…”