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40 Visit: http://image.idakunnamkulam.com/ 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. Visit : http://image.idakunnamkulam.com/ Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders
41 Visit: http://image.idakunnamkulam.com/ Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders Psychosocial Aspects Of Hemophilia Care A person with hemophilia and his family need psychological social support in coping with an illness that is chronic, often painful and sometimes life threatening. It is financially a burden and places restriction on several aspects of normal living. Psychological Support is an essential ingredient of any successful medical management Most effective when given by the primary physician. Simple to implement when essential techniques are applied. General Principles Provide privacy. Seat patient comfortably at eye level. Make eye contact Use open ñended questions, eg. ìHow are you feelingî rather that :how is the pain today?î This allows the person to express any problem being experienced rather than restricting him to only pain. Use simple languages; avoid medical jargon. Use body languages to advantage-leading forward, nodding, maintaining eye contact, avoiding making full notes while subject is speaking-are all powerful signals which convey empathy and interest. Use silences effectively. It is useful to pause statement that are likely to cause distress, eg. disclosure of diagnosis. Continue to display a listening posture. Important concerns and fear will be elicited. Visit : http://image.idakunnamkulam.com/ Hand book for dental surgeons on dental management of persons with hemophilia and other haemostatic disorders
Page 1 and 2: DENTAL MANAGEMENT OF PERSONS WITH H
Page 3 and 4: INDIAN DENTAL ASSOCIATION, KERALA S
Page 5 and 6: IDA KERALA STATE CDE CHAIRMANíS ME
Page 7 and 8: IDA KERALA STATE EDITORíS MESSAGE
Page 9: EDITORIAL Dental Surgeons face blee
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