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Concerns

Oral health care considerations for patients with bleeding disorders

Platelet disorders

Hemophilia A and B

von Willenbrand Disease

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Oral health care considerations for patients with bleeding disorders:

Platelet disorders:

  • >50,000 cells/mm³ – Routine dental procedures, including simple extractions.
  • 20,000-50,000 cells/mm³ – Platelet transfusions may be indicated for surgical procedures.
  • <20,000 cells/mm³ – No elective dental care.

Hemophilia A and B:

  • 50%-100% of factors for surgical procedures.
  • >50% of factors for routine dental care.
  • >30% of factors for mandibular blocks.
  • For mild cases, use DDAVP.
  • Consider antibiotic prophylaxis for patients with total joint replacements.
  • Factor replacement is calculated based on severity of disease and patient’s weight.
Hemophilia A – 1 unit of factor VIII (F VIII)/kilogram of body weight raises the F VIII level by 2%

(Example – A 70 kg person with hemophilia A needs 3,500 unit to raise a factor level from <1 to 100.)

Hemophilia B – 1 unit of factor IX (F IX)/kilogram of body weight raises the F VIII level by 1%.

(Example – A 70 kg person with hemophilia B needs 7,000 unit to raise a factor level from <1 to 100.)

von Willenbrand Disease:

Consider desmopressin acetate(DDAVP) for surgical procedures.

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