Hemophilia A: Dental considerations and management

Abstract

Aim:To review hemophilia A with emphasis on its oral manifestations, investigations, and dental management.Materials and Methods:Search was conducted using internet-based search engines, scholarly bibliographic databases, PubMed, and Medline with key words such as “Hemophilia A,” “factor VIII,” “bleeding and clotting disorders,” and “dental management.”Results:Hemophilia comprises a group of hereditary disorders caused due to the deficiency of one or more clotting factors leading to prolonged clotting time and excessive bleeding tendencies. It is broadly divided into hemophilia A, B, and C, which occur due to deficiency of factor VIII, IX, and XI, respectively. Hemophilia A is an X-linked recessive hereditary disorder and is the most common of the three, accounting for 80–85% of the cases.Conclusion:Understanding this complex entity is very important for a dentist to provide appropriate dental treatment and avoid undesirable consequences.

Dental management of a patient with incidentally detected hemophilia: Report of a clinical case

“…It is common in dental practice to encounter patients with bleeding disorders in daily practice; therefore, it is essential to be able to identify such patients and safely manage their dental treatment. [7]…”

Practical Recommendations for Treatment of Dental Patients with Congenital Bleeding Disorders during the Covid-19 Pandemic: A Narrative Review

“…There are discrepancies in dental health and oral hygiene in individuals with CBD [ 29 , 35 ]. The literature reports a frequent occurrence of osteoporosis in patients with hemophilia [ 36 , 37 ], as well as the possibility of complications related to hemorrhages into muscles and joints [ 38 ]. Complications include arthropathy, synovitis, contractures, or the formation of pseudo-tumors within the loco-motor system in the course of hemophilia.…”

Dental Management of a Child with Incidentally Detected Hemophilia: Report of a Clinical Case

“…Hemostasis disorders are classified as coagulation factor deficiencies, platelet disorders, vascular disorders, and fibrinolytic defects [ 1 ]. Hemophilia belongs to the first group of these diseases, clinically characterized by prolonged clotting time and excessive bleeding into mucosa, soft tissues, muscles, and weight-bearing joints [ 1 , 2 ]; joint bleeding or hemarthroses can result in debilitating arthropathy [ 3 ]. It has been associated with mortality and morbidity and therefore with numerous impacts on overall health [ 3 – 5 ].…”

“…This disease has been subclassified in three subtypes: A , representing 80–90% of total cases (or 1 : 5000 births), where females are carriers, males are only affected, and male-to-male transmission does not occur; B (Christmas disease), which is much less common (1 : 30,000 births); and C (Rosenthal syndrome), also very rare [ 3 , 8 ]. Additionally, a fourth type of hemophilia was proposed by the Norwegian physician Owren in 1947 [ 9 ], the Owren's disease or parahemophilia , caused by a deficient factor V, with an incidence of 1 case per 1 million children [ 1 , 10 ]. A and B types are clinically indistinguishable [ 3 ] and are caused by deficiencies of the coagulation mechanism factors VIII (or antihemophilic factor) and IX (or plasma thromboplastin component), respectively; C subtype results from a deficiency of factor XI [ 2 , 8 ].…”