Three exposures per day is the recommended maximum. The most common cause of excessive bleeding is idiopathic, but bleeding can also be caused by inherited or acquired conditions associated with vascular defects, platelet defects or coagulation disorders. Coagulopathy also called a bleeding disorder is a condition in which the bloods ability to coagulate form clots is impaired. Local treatments like direct pressure on the area using a damp gauze swab, maintained for at least 15 min must be considered. Properdental and medical evaluationof a patient is necessary before treatment. Changes in the mouth are oftentimes the first physical signs of an eating disorder.
In hemophilic children, the highly vascular oral cavity is frequent for hemorrhage episodes. Guidance for dental practitioners university of dundee. Provider education and training on bleeding disorders in. The essential guide for understanding and treating women with inherited bleeding disorders, revised and updated now in its second edition, inherited bleeding disorders in women includes the most recent developments and research in the field.
Recommendations for dental preventive strategies and treatment planning were originally developed through consensus. Cabay, md, dds abstract oral care providers must be aware of the impact of bleeding disorders on the management of dental patients. These disorders may be congenital or acquired and cause quantitative andor qualitative abnormalities in blood elements i. Defects in haemostasis can comprise abnormalities in platelet activation and function, contact activation or with clotting proteins, or may signal excess antithrombin function. Patients with bleeding disorders pose a challenge for dentists.
Management of bleeding disorders poses a challenge to dentists. Suturing of the wound, application of local hemostatic agents. The monograph adds to two previous wfh monographs on oral and dental care, prophylaxis and treatment. Haematology for dental students bleeding disorders. Learn about the different types of bleeding disorders and how theyre treated. This bleeding can be in many cases like during an accident, trauma condition, surgery, injury or a. The initial recognition of a bleeding disorder may occur in a dental practice. Oral bleeding and petechiae are typical manifestations, together with mucosal pallor and sometimes gingival swelling localized or generalized, mucosal or gingival ulceration, pericoronitis and cervical lymphadenopathy.
Dental management of patients with inherited bleeding disorders abstract. Bleeding disorders are relatively rare genetic disorders characterized by increased or prolonged bleeding due to abnormal coagulation the ability of the blood to clot. Response percentage of dentists to questionnaires was 89%. Proper dental and medical evaluation of a patient is necessary. Inherited bleeding disorders in women, 2nd edition. Identification and basic management of bleeding disorders. Dental procedures, such as extractions and periodontal surgery. Management of dental patients with bleeding disorders.
Disorders of the blood can affect the management of dental patients. These disorders must be recognized from history, clinical examinations, and laboratory investigations, if indicated, prior to surgical procedures including those in dental surgery to prevent bleeding related complications. Dental management of a child with incidentally detected. Pdf oral care providers must be aware of the impact of bleeding disorders on the management of dental patients. The aim is to ensure that the intake of food and drink does not cause the ph of the oral cavity to. The extent and severity of periodontal disease determines the necessity for a surgical or nonsurgical treatment approach in its management.
This paper will discuss and outline the dental management of patients with. Perioperative dental management strategies of value in patients with different congenital and acquired disorders of hemostasis are carefully explained, and the role of surgical techniques and local and topical agents in helping to minimize and control bleeding is described. Bleeding is a common symptom and does not always indicate an underlying bleeding disorder. By cathy hulbert, lcsw, and rueleen lavergne, rn, hemophilia of georgia outreach staff. October 20 dentalupdate 6 specialcaredentistry special care dentistry. Dental extractions in patients with bleeding disorders. Dental extraction, gingival bleeding due to poor oral hygiene, and trauma are the most common causes of oral hemorrhage. A number of procedures that are performed in dentistry may cause bleeding.
Aml in particular may cause gingival swelling in 2030% of patients. In normal clotting, platelets, a type of blood cell, stick together and form a plug at the site of an injured blood vessel. Nhs scotland advise everybody to see their dentist every six months if they have their own teeth or. Bleeding disorders of importance in dental care and related patient management anurag gupta, bds. Theinitial recognition of a bleeding disordermayoccur in a dental practice. Most of these conditions can be safely treated in the general dental practice. The second paper in this three part series discussed the dental management of patients with drugrelated acquired bleeding disorders.
Dental management of patients with medical conditions causing acquired bleeding disorders abstract. Some bleeding problems are congenital present at birth while others are acquired develop at any time during a persons life. The american academy of pediatric dentistry aapd recognizes that the pediatric dental professional plays an im portant role in the diagnosis, prevention, stabilization, and treatment of oral and dental problems that can compromise the childs quality of life before, during, and after immuno suppressive therapy which lowers the bodys normal. Cdc collaborates with public and private organizations in conducting research to better understand bleeding disorders affecting women and girls.
Bleeding disorders manifest with common bleeding features, including epistaxis and gingival bleeding, and may occur after wounds and surgery. Introduction a common complication that arises in patients with disorders of hemostasis after oral surgery is excessive bleeding. Review common bleeding disorders that occur in women of reproductive age. Evaluation the dentists awareness of inherited bleeding. Excessive bleeding due to oral surgical procedures is one of the most frequent complications in these patients. None of the 43 patients with coagulopathies other than severe hemophilia suffered bleeding after extractions. Unlabelled the most common cause of excessive bleeding is idiopathic, but bleeding can also be caused by inherited or acquired conditions associated with vascular defects, platelet defects or coagulation disorders. Dental management in patients with hemostasis alteration. Management of the dental patient who has a bleeding disorder requires an understanding of the normal hemostatic system and the patients specific coagulation. Dental complications of eating disorders national eating.
Pdf bleeding disorders of importance in dental care and related. Although patients with congenital bleeding disorders have an increased risk of significant bleeding from invasive dental and oral surgery procedures 1,2 the majority of routine nonsurgical dental. Characterization, dental considerations and management sara israels, md, frcpc. Dental considerations in patients with liver disease. Dental extraction in any patient with clotting factor defects can result in a delayed bleeding episode. Management of bleeding disorders in the dental practice. These conditions can be inherited, acquired, or congenital are associated with an increased risk of hemorrhage, poor wound healing. Using diagnostic symptoms and signs, identify women who may have a bleeding disorder. Congenital bleeding is often associated with a family history of bleeding and results from missing or poorly functioning clotting factors. Guidance pdf leaflet to print out and hand to your patients. Women with bleeding disorders can experience complications, such as heavy menstrual bleeding called menorrhagia and bleeding after pregnancy that can affect their overall health. This important guide offers the most current information available for the effective management of these complex and difficult to diagnose disorders.
Find information on bleeding disorder symptoms, causes, and complications. Success criteria for dental implant operations in patients. Bleeding disorders in orthodontics and their management. Bleeding disorders are conditions of varying severity that affect normal hemostasis, resulting in prolonged or excessive bleeding. It is very important that you receive regular dental care. Gingival swelling results from an abnormal response to dental plaque, causing the tissues to be. Bleeding disorder is a set of disorders, or disease which normally affect the process of clotting of our blood. This leaflet will be able to help you plan your treatment. Under normal circumstances, these procedures can be performed with little risk to the patient. Bleeding disorders can be inherited or acquired and demonstrate different levels of severity. Guidance on the dental management of patients with. This paper will cover inherited bleeding disorders. October 2007, submitted to the journal of the georgia dental association.
Scottish oral health group for medically compromised patients. Haematology for dental students bleeding disorders 1. Most guidelines for managing hemophilia and other bleeding disorders have been developed based on experiences in adults 3, 6, 7, 17. The first of this series of three articles discussed the dental management of patients with inherited bleeding disorders. Zaki kudsi mohamad hani nouri dalati, louna sibai and lara. This condition can cause a tendency toward prolonged or excessive bleeding bleeding diathesis, which may occur spontaneously or following an.
Both of the above share the common goal of debriding the root surfaces. However, if you have serious inflammation of the gums gingival or gum disease, you may need factor replacement therapy to control any bleeding. Currently, no universally standard protocol specific for affected children is available, to ensure a safe treatment in the clinical setting 8, 12. The best strategy to avoid these hemorrhagic complications in. Pipettes should preferably be accurate within signifi cantly less than 10%. Patients who are on anticoagulants represent a large group of bleeding disorders. Bleeding problems can result from diseased platelets or clotting factor abnormalities. Guidelines for dental treatment of patients with inherited bleeding disorders. Dietary habits can and do play a role in oral health. You have been diagnosed as suffering from haemophilia or another bleeding disorder.
Bleeding disorders can be classified as coagulation factor deficiencies, platelet disorders, vascular disorders, and fibrinolytic defects. Bleeding disorders of importance in dental care and. Every clinician will encounter a patient who complains of prolonged bleeding following certain procedures. Guidelines for dental treatment of patients with inherited bleeding disorders 3 the consumption of foods and drinks with a high sugar or acid content should be limited to mealtimes.
Oral care providers must be aware of the impact of bleeding disorders on the manage ment of dental patients. Bleeding disorders of importance in dental care and related. Archie mcnicol, bsc, phd abstract hemostasis is a finely balanced process in which an insult to a blood vessel wall, either by. Bleeding disorders of importance in dental care mount sinai. The fewer tooth problems a child has, the fewer repairs are needed, and the less bleeding will occur. Symptoms such as gum bleeding, epistaxis, menorrhagia, petechiae, and bruising are especially common. The harmful habits and nutritional deficiencies that often accompany disordered eating can have severe consequences on. Dental care with a bleeding disorder childrens minnesota. Bleeding disorders are a group of conditions that result when the blood cannot clot properly. In the present research, dentists awareness of dentistry procedures for individuals suffering from bleeding disorders was assessed to be at a moderate level 69. Diagnosis of hemophilia and other bleeding disorders.
A diagnostic overview abhirup goswami 1, amitava bora 1, gautam kumar kundu 2, samiran ghosh 3, anupam goswami 4 1 final year post graduate trainees, department of pedodontics and preventive dentistry, guru nanak institute of dental sciences and research, kolkata, india 2 professor and head, department of pedodontics and preventive dentistry, guru nanak. Review of existing studies and guidelines atanaska dinkova1, donka kirova1, delyan delev2 1 department of oral surgery, faculty of dental medicine, 2 department of pharmacology and clinical pharmacology, medical university plovdiv, bulgaria. Department of orthodontics and dentofacial orthopedics, saraswati dental college hospital lucknow,uttar pradesh, india. Bleeding disorder an overview sciencedirect topics. At the end of the session student will be able to, discuss normal hemostasis, how bleeding stops. If a pipette is inaccurate beyond the following limits mean weight, it must be taken out of use immediately. Bleeding disorders coagulation disorders jama jama. This paper will discuss and outline the dental management of patients with acquired bleeding disorders that can result from drug therapy. Bleeding disorders slideshare uses cookies to improve functionality and performance, and to provide you with relevant advertising.
You may need to be referred to the hospital for treatment. Safe dental care may require consultation with the patients physician, systemic management, and dental treatment modifications. Local use of fibrin glue is a safe and costeffective tool to treat patients with severe bleeding disorders. Excessive bleeding in these patients is not only distressing for the patient, but also hinders the completion of the procedure e. Initial recognition of a bleeding disorder, which may indicate. Dental management of adult patients with haemophilia and other congenital bleeding disorders.
1095 589 429 1609 919 1251 1171 1394 1542 536 1021 106 1228 1584 1396 793 1285 1362 427 1071 1013 1116 503 1320 1269 1116 921 552 1286 1074 215 1264 1108 613