Can A Patient With Hemophilia Have Dental Treatments?


Dental professionals play a crucial role in maintaining the overall health of their patients. They recommend that everyone follow proper daily hygiene practices and have biannual visits to the dental clinic for dental check-ups and professional teeth cleaning in order to avoid mouth bleeding and prevent the requirement of major dental procedures.

In day-to-day dental practice, dentists encounter different kinds of patients with various dental issues. Among them, some may suffer from various types of bleeding disorders that can be classified as vascular disorders, coagulation factor deficiencies, fibrinolytic defects, and more. The most common coagulation defect disorder mentioned in this blog is Hemophilia and its link with dental health.     

What is Hemophilia?

Hemophilia is a medical condition that refers to a group of hereditary disorders caused due to clotting factor deficiencies resulting in delayed clotting time and a tendency to bleed excessively, which may be life-threatening. Broadly, it comprises Hemophilia A (deficiency of factor VIII), Christmas disease or Hemophilia B (deficiency of factor IX), or Rosenthal syndrome or Hemophilia C (deficiency of factor XI). 

How Does a Hemophilia Condition Affect Dental Treatments?

Hemophilia induces unstoppable bleeding during dental treatments that can be fatal in some cases. Its presence in the patient undergoing any dental work can challenge the skills of dental specialists. The high incidence of dental concerns in hemophilia patients poses difficulty in their dental management both psychologically and emotionally. Still, these patients can be treated for dental problems with proper care and precautions under the supervision of experts. 

What Extra Care is Required for Hemophilia Patients Who Are Seeking Dental Treatments? 

If a patient has hemophilia, it is advised to ask their oral health care professionals whether bleeding is likely to occur during their dental work. Although slight bleeding is not a threat to overall health, persistent or excessive bleeding can make dental treatment more difficult and may extend the timing of dental appointments or require a follow-up visit. Hence, hemophilia patients must submit an information sheet from their bleeding disorder treatment center to their dentists that tell the type and severity of their bleeding disorder. This can help the dental team know whom to contact for advice at the hemophilia treatment center.

In treating hemophilia patients, the hematologists from the treatment center may prescribe pre-treatments before going for dental surgeries. This includes providing infusions of clotting factor concentrates or other medications such as tranex-amic acid (cyklo-kapron)/ desmop-ressin that can control bleeding. 

Most common dental procedures or dental hygiene practices that require treatment to control bleeding and ensure that they are safely performed include:

  • Tooth extractions
  • Deep scaling or root planing
  • Any oral surgery
  • Any dental service where it is expected that more than minimal bleeding will take place
  • Local anesthesia or freezing injections including the mandibular block (for the backside of the lower jaw) and lingual infiltrations (i.e. the sides of the tongue).   

Individuals that have bleeding disorders are still encouraged to have routine dental exams and cleanings that usually do not need any pre-treatment with clotting factors. They are also reminded to not wait for their hematologists to spot any serious dental problems such as gum disease. 

Tips to Minimize Postoperative Bleeding:

  • Get proper rest by keeping your head elevated to slow down blood flow, which further stops bleeding and promotes quick healing.
  • Avoid alcohol intake and chewing/smoking tobacco for the first few weeks post-dental surgery. This can help prevent infection leading to bleeding and makes blood clotting much easier, thereby allowing quick recovery. 
  • Do not use straws or any food item with sharp edges and avoid vigorous mouth rinsing as this can dislodge the blood clot formed at the treatment site.
  • Stop or discontinue the intake of non-steroidal anti-inflammatory medications and aspirin or blood thinners that can increase bleeding. 
  • Refrain from strenuous exercise that increases blood pressure for a few days after the surgery, as this can lead to bleeding at the surgical site inside the mouth.
  • Eat soft, cold, and mild-flavored food items or drinks to help preserve the blood clot.

If you are suffering from hemophilia and are afraid of visiting a dentist, then this may cause more damage and can increase the risk of secondary infections. Please consult a professional dentist to ensure oral health and prevent the onset of future oral health concerns.

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