Dentists & Allied Healthcare Professionals
Dental procedures and hemophilia
Bleeding inside the mouth or gums is a common type of bleed in people with hemophilia. Certain dental procedures (like tooth extractions), which are common in kids, can cause prolonged bleeding in a patient with hemophilia. While the bleeding can usually be managed, by applying direct pressure or with factor infusion treatment complications may arise if the bleeding occurs repeatedly.
For this reason, special care must be taken when treating a patient with hemophilia. If you’re a dental professional, ask parents how severe their child’s hemophilia is, how their child is treated, and what to do in the event of a bleed. If needed, consult their medical care team for more information. Here are a few precautions to keep in mind:
- Encourage the child to floss regularly and to brush their teeth with a soft brush. Flossing may cause a small amount of blood to ooze from the gums at first, but as the gums get healthier, the oozing stops.
- Before any dental procedures (e.g., fillings, tooth extractions, etc.), talk to parents about any preventative factor infusion treatment or medications such as tranexamic acid that may be needed has been coordinated. Sometimes extensive dental work requires a trip to the operating room for treatments under anesthesia.
- Special care should be used when performing routine dental procedures, such as use of saliva ejectors, removal of impressions, and placement of X-ray films, to avoid damage to the oral mucosa
- Monitor the child for a period of time after a tooth extraction (for signs of bleeding)
- Discuss with parents what treatment should be given should a bleed occur during a dental procedure
For more detailed information, consult The World Federation of Hemophilia Guidelines for Dental Treatment of Patients with inherited Bleeding Disorders. Download the Guidelines here
Allied healthcare professionals
Allied healthcare professionals are those that provide supportive care that is distinct from medical care. They include physiotherapists, social workers, dental hygienists and psychologists.
Physiotherapists, for example, play an integral role in the care of a person with hemophilia because joint damage is a common complication in people with hemophilia. Physiotherapy can help ease pain and stiffness, and improve overall quality of life.
It’s important for allied healthcare professionals, patients, and families to work together closely so that a safe and effective treatment plan can be developed.
MYTH: People with hemophilia can bleed to death from minor cuts.
FACT: External wounds or cuts are usually not serious. But, internal bleeding can be serious. Internal bleeding can occur in the joints (especially the knees, ankles or elbows) and vital organs.
A booklet for people living with milder forms of hemophilia, developed by the Atlantic Hemophilia Nurses Group of the Canadian Association of Nurses in Hemophilia Care (CANHC).Download PDF on Mild Hemophilia