Dental habits and oral health in children and adolescents with bleeding disorders: A single‐institution cross‐sectional study

Abstract

Introduction Oral health is an important component of care at haemophilia treatment centres (HTCs). Correlations between oral health and inflammation suggest that proper oral health may improve joint health. Aim To evaluate the dental habits, needs, and oral health status of paediatric patients with bleeding disorders, and identify predicters of poor oral health. Methods From May 2016 to October 2017, consecutive paediatric HTC patients completed a 14‐question survey and were examined by dental professionals. Descriptive analyses, chi‐square tests and logistic regression models identified characteristics associated with four main dental outcomes. Results Evaluations from 226 consecutive patients (age 1–20 years) were included. Diagnoses included haemophilia A and B (64%), von Willebrand disease (25%) and other bleeding disorders (13%). Nearly half of patients reported not brushing their teeth twice a day (44%). One‐quarter of patients did not currently have a dentist (27%), and 15% reported specific challenges with access to dental care. Oral screening demonstrated significant pathology: 89% of patients had plaque accumulation, 37% had gingivitis and 8% had lesions suggestive of dental caries. Multivariate analysis revealed that having a primary caregiver with active decay was associated with significantly higher rates of suspicious lesions (OR 4.34, CI 1.41‐13.35) and gingival erythema (OR 3.44, CI 1.63‐7.25) and lower rates of twice daily teeth brushing (OR .17, CI .08‐.37). Conclusion Children with bleeding disorders commonly have significant dental pathology and report obstacles to dental care, posing the potential risk for morbidity. Primary caregiver dental health is strongly associated with dental pathology in children.

Oral health in individuals with bleeding disorders: A systematic review and meta‐analysis

“…By collating and critically analysing existing research, we strive to provide a comprehensive overview of the current state of knowledge regarding this crucial subject. The meticulous examination of the available literature has revealed that there have been numerous studies assessing different oral health components in individuals with bleeding disorders [4][5][6][7] ; however, a comprehensive pooled estimate of the different oral health conditions has not been carried out.…”

Optimization artificial neural network classification analysis model diagnosis Gingivitis disease

“…Oral and dental health is a difficult thing to pay attention to for the community, especially among children [3]. This will later lead to the development of disease due to a minimal of attention to hygiene and oral and dental health [4].…”

Post‐procedural bleeding rate and haemostatic treatment use for dental procedures before and after the implementation of a standardized protocol for people with inherited bleeding disorders

“…Inherited bleeding disorders, notably haemophilia A and B, von Willebrand disease, other coagulation factors deficiencies, and platelet disorders, affect many people globally. [1][2][3] Severe and moderate haemophilia (factor VIII or IX activity < 1% or 1-5% of normal, respectively) are associated with spontaneous joint and muscle bleedings. 4,5 Spontaneous bleedings are more rarely encountered in mild haemophilia (factor activity: 6-40% of normal) and other inherited bleeding disorders, but bleeding can occur following trauma or surgical or dental intervention.…”

“…Inherited bleeding disorders, notably haemophilia A and B, von Willebrand disease, other coagulation factors deficiencies, and platelet disorders, affect many people globally 1–3 . Severe and moderate haemophilia (factor VIII or IX activity < 1% or 1–5% of normal, respectively) are associated with spontaneous joint and muscle bleedings 4,5 .…”

“…Maintaining adequate oral health is crucial for persons with inherited bleeding disorders 11 . However, the prevalence of many oral diseases appears to be higher in persons with haemophilia, as the bleeding risk restricts access to dental care 3,12,13 . While the status of oral health and access to dental care is not as well‐established in individuals with other bleeding disorders compared to haemophilia A or B, it is likely that they experience similar barriers to care, given the limited experience of several dentists with inherited bleeding disorders 14 …”