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
Endodontics
Endodontic treatment is generally low risk for patients with bleeding disorders. If a pulpectomy is indicated, the
possibility of the tooth requiring conventional endodontic treatment must also be considered. It is important that
the procedure be carried out carefully with the working length of the root canal calculated to ensure that the
instruments do not pass through the apex of the root canal. The presence of bleeding in the canal is indicative of
pulp tissue remaining in the canal. Sodium hypochlorite should be used for irrigation in all cases, followed by
the use of clacium hydroxide paste to control the bleeding. Formaldehyde-derived substances may also be used
in cases where there is persistent bleeding or even before the pulpectomy.
COMMUNITY DENTISTRY AND HEMOPHILIA
All patients with hemophilia should be assessed for treatment needs, not only in the procedure that
should be undertaken, but also in the time it would take to carry out such procedure, so that if an opportunity
developers at some time in the future, they could be called up at short notice and have their dental needs
attended to. This identification of persons with hemophilia would not only allow their dental treatment needs to
be unidentified, but also allows this group of patients and their families to be specially targeted with the
preventive dental care message to reduce the progression of existing disease and diminish future dental
treatment needs.
Patients with hemophilia are different from ordinary patients in that the latter group can have multiple
visits to achieve a definitive treatment even on one tooth. this is luxury that it is not usually available to persons
with hemophilia: therefore, a much more restrictive view should be taken assessment of the necessity of
treatment must be taken, as there may be only one opportunity for dental intervention to take place. So by
definition, the options available to the dentists responsible for making the decisions for treatment of persons
with hemophilia are much more restricted. There are multiple causes for this including costs, availability of
service, and availability of factor replacement post-operative care.
In relation to infiltration anesthesia used mainly in the upper jaw, a 30% factor rise is a normal requirement.
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Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders