Dental Care for Children with Hemophilia Managing Bleeding Risks and Oral Health

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Hemophilia is a genetic bleeding disorder characterized by a deficiency in clotting factors, primarily factor VIII or IX, which leads to impaired coagulation and prolonged bleeding episodes. This condition presents significant challenges in dental care, especially for children. Hemophilic patients are prone to spontaneous bleeding in the oral cavity, particularly from the gingiva, due to the high vascularization of oral tissues and the frequent exposure to mechanical trauma. Common oral manifestations include gingival bleeding, periodontal disease, and dental caries, which are exacerbated by difficulties in maintaining proper oral hygiene. The pathophysiology of hemophilia disrupts the normal coagulation cascade, making even minor dental procedures, such as cleanings or fillings, risky without adequate preparation. Prophylactic treatment with clotting factor replacement therapy is often necessary before invasive procedures to reduce the risk of excessive bleeding. Additionally, the use of antifibrinolytic agents and local hemostatic measures, such as sutures or fibrin sealants, helps control bleeding during dental interventions. Children with hemophilia also face an increased prevalence of dental caries and periodontal disease due to the challenges in maintaining oral hygiene and the frequent consumption of sugary medications. These factors lead to a higher incidence of dental issues that require special management strategies. Preventive care, including regular dental check-ups, fluoride treatments, and minimally invasive procedures, is critical to reducing the need for more complex interventions. Successful management of dental care in hemophilic patients requires a multidisciplinary approach involving collaboration between dentists and hematologists. Individualized care plans tailored to the severity of the condition and the type of dental procedure are essential to minimize bleeding risks and ensure safe and effective treatment. Advances in dental technologies and treatment approaches continue to improve the outcomes and quality of life for children with hemophilia.