Clinical Characteristics and Implications for the Dental Provider

Figure 5: Characteristics and Special Considerations

Observing the clinical characteristics of the patient’s oral cavity along with developing a precise treatment plan, has significant implications for the patient. It is through these observations that the dentist must accurately convey the projected level of hemostatic challenge to the hematologist. Including specific details of the planned procedure is important, such as type of injection used (i.e. local submucosal infiltration, block anesthesia, involvement of bone vs soft tissues only, number of teeth extracted, staged procedures such as implant, etc. In turn, the hematologist will decide the appropriate factor coverage and treatment duration based on what has been observed and reported by the dentist.

Oral bleeding is extremely common with any genetic bleeding disorder, with up to 90% of individuals with hemophilia A experiencing oral bleeding at some point in their lives (Figure 6). As noted in Figure 6, oral cavity bleeding is a significant symptom of every bleeding disorder. Oral cavity bleeding is spontaneous and often reported by patients as a source of fear, frustration, and decreased quality of life.