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
Efficient use of aspiration equipment facilities dental procedures for the anesthetized child. A mouth prop may
be used, when needed, to keep the childís mouth open. For any restorative treatment on the anesthetized patient,
use of rubber dam provides the dentist with a dry field and better visibility, and serves as an adjunct to the throat
pack in preventing debris from entering the patientís throat. Prior to extractions or other surgical treatment, all
restorative procedures should be finished; with this done, the mouth should be cleaned, the throat pack replaced
with fresh gauze, and the surgical procedures initiated.
Upon completion of the planned treatment, any hemorrhage must be controlled and all debris carefully
evacuated from the oral cavity; after this, the throat pack can be removed and the child taken to the recovery
room.
Before hospital dismissal, an appointment should be set up for a postoperative check on the patient
within the following two weeks. On this visit, the parents must be impressed with the urgency for careful oral
home care for their child and reducing his intake of cariogenic food as a means of avoiding the ordeal or
repetitive dental treatment.
Despite the fact that different blood components are involved en each of bleeding and clotting diseases,
their clinical and oral manifestations are identical. They will therefore be described together as a single disease.
Oral Manifestations. Hemorrhage from many sites in the oral cavity is a common finding in
hemophilia, and gingival hemorrhage may be massive and prolonged. Even the physiologic process of tooth
eruption and exfoliation may be attended with severe prolonged hemorrhage.
The oral manifestations of the various forms of hemophilia have been discussed by Spiegal and by Steg
and his co-workers. In addition, mandibular ìpseudsotumorî of hemophilia has been reported by Stoineman and
Beierl, a condition in which there is subperiosteal bleeding, with reactive new bone formation causing tumor-
like expansion of the bone.
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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders