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Haemophilia is a disease manifested by bleeding that can be caused, among others, by dental treatments. For this reason, dentists are reluctant to treat patients with hemophilia, which in turn leads to the development of advanced caries and the need to remove teeth. However, as the dentist, Dr. Grzegorz Czubaki, the patient can effectively protect himself against bleeding and start treatment without fear.
Hemophiliais a bleeding disorder - a disease that manifests itself through bleeding. They may appear, among others while brushing your teeth. For this reason, especially children, avoid brushing their teeth long enough and frequently, which leads to the development of caries. Then a visit to the dentist is necessary, but also during dental procedures, bleeding may occur. For this reason, doctors are reluctant to treat people with hemophilia, which in turn leads to the development of advanced caries and the need to remove teeth. However, as the dentist, Dr. Grzegorz Czubaki, who struggles with hemophilia himself, tooth extractions do not have to be the only possible form of dental treatment in patients with this hemorrhagic diathesis. It is enough to skillfully protect the patient against bleeding.
As a person with hemophilia, do you have any special rules for brushing your teeth? Do you avoid floss or use a special toothbrush?
There is no need for this as there are no specific oral hygiene rules for patients with hemophilia and other bleeding disorders. They are the same as for everyone - no reduced fare. I would only recommend caution when using a toothpick, but this applies to all patients, not just those with hemophilia.
What about children who have to wear braces? Should orthodontists be treated differently in the office than their he althy peers?
Blood coagulation disorders are not a contraindication to orthodontic treatment of both children and adults. Therefore, they can use the same devices as other patients. On the other hand, bleeding from the gums lasting a few or several days during the replacement of milk teeth with permanent teeth may be troublesome (therefore, as a child, I was hospitalized several times). To avoid them, loose deciduous teeth should be removed,causing bleeding. Then wearing braces will not be a problem.
Should a patient with hemophilia prepare for a visit to the dentist in any particular way?
No. In the case of bloodless procedures, there is no such necessity. And when we know that blood may appear in the mouth, the patient should, in consultation with the dentist and the attending physician, take a clotting factor. Then bleeding will be reduced and clotting will be normal. A minor trauma to the mouth will not be a problem. In the case of tooth extraction or removal of tartar, the patient should be prepared with the appropriate amount of the clotting factor. People with hemophilia are very conscious patients, and both adults and parents of children with hemophilia are well prepared for these challenges. You only need to work well with such a patient - talk to them and carefully establish a treatment plan.
Only a few dozen years ago, patients with hemophilia were hospitalized after tooth extraction. How is it today?
You just need to give your coagulation factor. Situations when the patient has to be hospitalized for this reason are very rare. The trouble is with those patients who have the anticoagulant. This antibody causes that the administration of a normal blood clotting factor is not sufficient to provide adequate protection. And if in their place of residence these patients do not have haematological consultation and extended access to drugs, they should stay in the hospital for observation.
Do people with hemophilia have weaker teeth?
I don't see such a relationship. Unfortunately, hygienic negligence more often leads to problems in them than in he althy patients. This is because people with hemophilia sometimes neglect oral hygiene, fearing bleeding from the gums. The result is the appearance of plaque around the necks of the teeth, the remaining of which leads to inflammation of the gums and then causes bleeding when brushing. There is a vicious circle effect. To avoid this, brush your teeth frequently, thoroughly and systematically. Of course, a soft brush and non-aggressive paste are recommended.
In spite of your illness, you graduated from university, started working and works normally …
Yes. However, when I was admitted to college, after some time I heard: "If we had carefully read the documents you submitted and noticed that you had hemophilia, we would not have accepted you …". Those were the times. I have been practicing this profession for 33 years and my illness has never bothered me. Despite the severe hemorrhagic diathesis, I also care forphysical fitness. Thanks to this, I try to function and work like a he althy person.
Source: Medicinaria, 3rd edition, "Hemophilia - a rare blood disease", June 2015. Organizer: "Journalists for He alth" Association.