According to the Centers for Disease Control and Prevention (CDC), around 17,000 people in the United States suffer from hemophilia. People with the disease can bleed for a long time after an injury, which increases the risk of complications after certain invasive procedures. As such, people with hemophilia must carefully consider the additional risks dental implant surgery can pose. Find out how hemophilia affects your body, and learn more about the precautions you should take if your dentist recommends dental implants.
How hemophilia affects the body
Your blood clots naturally because of special proteins in the body. These proteins (or clotting factors) help the platelets in your blood stick together to stop blood leaking from the vessels when you cut or bruise yourself. People with hemophilia have little or no clotting factor in their blood.
Doctors diagnose two types of hemophilia:
- Type A occurs when you have little or no clotting factor 8. Around 80 percent of people with the disease have type A.
- Type B occurs when you are missing clotting factor 9.
Most people inherit hemophilia from their parents, and the disease normally only affects males. Occasionally people acquire the disease when the body forms antibodies that attack and damage clotting factors in the blood.
People with hemophilia are at higher risk of deep internal bleeding. People with the disease tend to have a lot of blood transfusions, which can increase the risk of infectious diseases. Joint damage can also occur.
The risks of dental treatment
Dental treatment can pose a risk to patients with hemophilia because these procedures often cause trauma and bleeding of the gums. That aside, with careful preventive care, dentists can safely and effectively carry out a range of treatments for people with hemophilia.
The side effects of hemophilia vary between patients, and you may suffer mild, moderate or severe symptoms depending on your clotting factor deficiency. Around 70 percent of people with type A hemophilia have the severe form of the disease, so it’s important to consult a specialist before carrying out dental treatment.
If you have mild hemophilia (with at least 5 percent clotting factor), you can visit a normal dentist for routine care. This treatment can include check-ups, fillings, scale and polish and even root canal treatment. You can also have some dental implants, including crowns and other cosmetic work. In all cases, you should always tell your dentist about the condition and any medications your specialist prescribes for you.
If you have more severe hemophilia, you may need to undergo dental treatment in a specialist centre. What’s more, even patients with mild hemophilia may need to see a specialist for more invasive procedures. Deep injections, gum surgery and some dental implants can all cause complications, so speak to your consultant for more advice.
Special precautions a dentist may take with your hematologist
If you need certain dental implants, your dentist will need to work with a hematologist as part of a hemostasis management plan. This plan may use several treatments to replace or boost the clotting factor, including:
- Infusions of clotting factor or desmopressin (a synthetic hormone replacement)
- Clot-preserving medications or antifibrinolytics
- Fibrin sealants, which the dentist applies directly to the wound to promote clotting and healing
After implant surgery, a specialist may also recommend tranexamic acid or epsilon aminocaproic acid, to stop excessive bleeding.
What you can do following dental implant surgery
If you have dental implants, it’s important you take special care after surgery. You should avoid hot and cold drinks and food until normal feeling returns. Avoid smoking, and rinse your mouth regularly with a salt water mouthwash.
Report prolonged bleeding or difficulty swallowing to your dentist immediately. He or she may prescribe paracetamol/acetaminophen painkillers to help control pain, but you should avoid non-steroidal anti-inflammatory drugs and aspirin, as these medications can interfere with the clotting process.
Hemophilia is a serious condition that can cause severe side effects after surgery. People with the disease can safely have dental implant surgery, but your dentist may need specialist support during the procedure.Read More