Care Coordination

It is essential to contact a patient’s hematologist to communicate the proposed dental treatment plan, including anticipated levels of bleeding. The hematologist will work with the patient to plan for a factor infusion before the dental procedure to ensure clotting factors are at the optimal level. Many patients are already on prophylaxis which brings their factor levels into near normal range to minimize spontaneous bleeding.

The dental provider must remind the patient of the hematologist’s pretreatment plan prior to the appointment to confirm that the patient has successfully completed the required pretreatment. This is a critical step prior to providing any dental procedure(s). If the patient is not in compliance with the pretreatment plan, the dental provider should reschedule the appointment. Confirmation of the conversation with the patient must be documented in the patient’s chart.

All dental surgery should be performed early in the week (ideally on a Monday or Tuesday) in case an emergency should arise. By scheduling treatment in this manner, the dental provider and patient have quicker access to the hematologist and HTC versus an emergency occurring over the weekend. Should an emergency occur on a Friday, it may be difficult to obtain medications or testing in the hospital needed to treat the bleeding disorder.