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
HEMOPHILIA AND CHILDREN (PEDODONTICS)
Several inborn abnormalities of metabolism, which manifest themselves as hemostasis disorders, have
been given the collective name hemophilia. these disorders may result from lack of any one of the substances
necessary for normal thromboplastic activity.
The most common hemophilic condition is the disorder caused by dificiency of factor VIII
(antihemophilic globulin). This condition is transmitted as an X-linked mendelian recessive and occurs
exclusively in males. Although children born with factor VIII deficiency are potential ìbleedersî from birth,
excessive bleeding may not be observed until increased activity begins, at about 6 months of age. Bleeding may
occur from any site, but is most common in the muscles, kidneys, mouth, and joints. The knee joints of the
infant who is beginning to walk are especially vulnerable.
DENTAL PROBLEMS
Although the hemophiliac has no characteristic dental problems, any dental treatment these children
require must be considered as serious because of the grave risks involved. The necessity for good oral care and
prevention of dental disease for the hemophiliac cannot be overemphasized, since preventive dentistry for these
children minimizes the need for the hazards of restorative treatment.
Dental Treatment
Even during the most routine dental treatment for the hemophilic child the dentist must exercise extreme
caution to prevent tissue lacerations. Scaling and polishing, reduction of subgingival tooth structure, and
adaptation of matrix bands must be managed with great care to maintain the integrity of the periodontal tissues.
Should minor bleeding problems occur, they can usually be controlled by pressure packs in conjunction with
hemostatic agents such as thrombin.
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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders