hand book for dental surgeons - Indian Dental Association ...

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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders
Introduction
HEMOPHILIA
Hemophilia is a hereditary disorder of coagulation results in deficiency of factor VIII (Hemophilia A) or
factor IX (haemophilia B). The disease is almost exclusively see in males while females are asymptomatic
carries. Rarely it can affect females. It can also be caused by mutation. It is characterized by spontaneous or
trauma related bleeding typically into the large joints or muscles. Untreated or inadequately treated episodes
lead to joint, muscles or nerve damage. Life threatening haemorrhages can result spontaneously or from trauma
to the head or internal organs.
Without proper care, hemophilia can lead to serious damage to limb and joint function within the first
one to two decades of life. This is due to impaired joint mobility, contractures, muscle atrophy and chronic pan.
Crippling joint deformities can be effectively prevented by adequate care of each episode of bleeding, including
replacement of the appropriate coagulation factor lacked by the patient and every deliberated and persistent
physical therapy. Certain serious complications can further complicate the management of hemophilia.
Between 10-20% of people with hemophilia A and 23% of those with hemophilia B develop inhibitors against
the deficient factor. Such patients do not respond to usual factor replacement therapy. Patients exposed to
factor replacement with products that have not been virus inactivate are prone to acquiring transfusion
transmitted viral infections such as human immuno-deficiency virus (HIV), hepatitis B and C viruses. The care
of people with hemophilia therefore often requires a multidisciplinary team to address different aspects of the
patientís problems. This is the concept of comprehensive care that is recommended by the World Health
Organization (WHO) and the World Federation of Hemophilia (WFH).
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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders