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Dental Care

People with bleeding disorders aren't more likely to have dental problems. However, those who don't take good care of their teeth are at an increased risk for complications if dental problems do develop. Preventing dental problems and maintaining a healthy mouth are important to help preserve quality of life and to avoid the risks of dental procedures, in particular, surgery.

Frequently, people with bleeding disorders and their families are so busy managing the disorder that dental care may be neglected. However, because oral health affects overall health, good dental habits and care are critical. Ideally, dental care should start when your child is young, so a good preventive program can be put into effect.

Finding a Dentist

For a child with hemophilia or other bleeding disorder, it's important to find a dentist who knows about bleeding disorders and your child's overall care plan. When you find a dentist with whom you and your child are comfortable, put him or her in touch with your Hemophilia Treatment Center (HTC). If you cannot find a primary dentist, contact your HTC. Often they can recommend a dentist or they may have one as part of their comprehensive care team.

Together, they can develop an appropriate dental treatment plan and make certain that procedures are performed safely. If your child has an emergency, a primary dentist should know how to manage bleeding complications. Be sure to talk to your dentist about your child's bleeding disorder and special needs: tell your dentist if your child is on prophylactic therapy and how you treat any bleeding episode. Be sure to ask your dentist about the risks of any procedure, especially if a local anesthetic is needed. Because the anesthetic is sometimes injected in an area with major blood vessels, you should understand the risk beforehand and have time to consult with your HTC.

The Goal of Good Dental Care

It's never too early to start taking good care of your child's teeth. Even newborns should have their mouths and gums gently cleaned with a soft gauze pad after every feeding.

The gums (called gingiva), which are soft tissue, cover the bones surrounding the roots of the teeth. One of the early stages of gum disease (called periodontal disease) is gingivitis, a swelling of the gums caused by bacteria. One of the first signs of gum disease is spontaneous bleeding.

Gum disease is a much more difficult problem for people with bleeding disorders because they will bleed longer. Treating the bleed with clotting factor or other therapies may temporarily stop the bleeding but not the underlying gum disease.

To prevent gum disease, teach your child to brush his or her teeth and floss regularly. Healthy gums do not generally bleed, even in a person with a bleeding disorder. You may see some bleeding, however, if your child brushes too hard. Do not stop the brushing or flossing routine if light bleeding occurs. If bleeding lasts longer than 20 minutes or stops and starts again, contact your Hemophilia Treatment Center (HTC).

A consistent brushing and flossing routine can help prevent gum disease, maintain a healthy smile, and protect teeth for a lifetime!

Brush Up on the Basics of Dental Care

Brushing and flossing are very important for keeping gums and teeth healthy.

Here are some extra steps you can take to ensure dental health:

  • Limit sugary food and drink
  • Keep regular dental appointments
  • Talk with your dentist about fluoride treatments
  • Start preventive dentistry when baby teeth begin to come in
  • Don't pull on loose baby teeth
  • Don't let your child run with anything in his or her mouth

Treatment

  • Contact your Hemophilia Treatment Center (HTC) or a hematologist before any dental procedures. The HTC and the dentist will work together to:
    • Decide what clotting factor or other treatment might be needed based on the severity of the bleeding disorder and the type of dental procedures planned
    • Treat any mouth infections with antibiotics before doing any surgical procedure
    • Control bleeding (for example, with special procedures and rinses)
  • If pain medication is needed, do not use any medicine, such as aspirin, that increases bleeding
  • Ask your dentist or doctor about a special diet after dental procedures, particularly a tooth extraction, to reduce bleeding
  • Follow all necessary steps outlined by the HTC and dentist before any dental procedure, whether surgical or not