Evaluation of Oral and Dental Health Status in Hemophilic Children and Adolescents in the City of Rasht

Abstract

Patients with hemophilia need special care and attention in dentistry. Thus, we assessed the oral and dental health status in children and adolescents with hemophilia in Rasht, Iran. Materials and Methods: In this case-control study, 53 hemophiliac patients (A and B), 2-15 years of age, and 53 healthy children were assessed. A checklist including demographic data was filled out and the subjects were examined by one dentist. The patients were assessed for modified gingival index, plaque index (PI) and Decayed-missing-filled teeth [(DMFT) in permanent teeth and Decayed-missing-filled teeth (dmft) in primary teeth)] indices. Data were analyzed with SPSS 19 at a significance level of p<0.05. Results: The mean age of the subjects was 10.49±4.21 years in the case group and 10.5±4.07 years in the control group. 92.5% of the patients exhibited factor VIII deficiency and the most frequent blood group was A (34%). 63.2% of the subjects in the hemophilia group and 13.2% in the control group had a history of bleeding that was significant (p=0.0001). There were significant differences between the two groups in bleeding at tooth eruption and exfoliation sites of deciduous teeth (p=0.0001), flossing (p=0.046), toothpick use (p=0.02) and the history of dental education (p=0.014). No significant difference was found between dmft and DMFT scores between the two groups but DMFS was significantly higher in the hemophilia group (p=0.007). There was also a significantly higher PI in the hemophilia group (p=0.003). Conclusion: Considering some unsatisfactory oral health conditions in these patients, dental health care and prevention seems necessary and can be effective in the prevention of dental problems, bleedings and complex treatments.

Can Hemophilia Impact on the Oral Health Conditions of Children and Adolescents? A Systematic Review and Metanalysis

“…For example, some studies indicate that hemophiliacs have a lower prevalence of dental caries [9][10][11] than individuals without hemophilia, while other authors found no association [4,[12][13][14][15][16] or found a positive association [6,7,17] between dental caries and hemophilia. Similar contradictions are found for other oral conditions, such as oral hygiene patterns or periodontal disease [4,6,7,10,[13][14][15][16][17][18][19][20][21][22].…”

“…Sixteen studies involved individuals with hemophilia from hospitals or centers specialized in hematological treatment [4,6,7,9,12,14,[18][19][20]30,31,[33][34][35][36]38]. Four studies with hemophiliacs from university clinics [10,15,17,32]; two studies that used national records of hemophiliacs [11,22]; two studies did not report such information [13,16,19,21,39]. Two studies showed results from the same sample [11,22].…”

“…Two studies used national hemophiliac's registers [11,22]. No recruitment data have been reported in three studies [13,19,39].…”

Inherited bleeding disorders in oral procedures. Assessment of prophylactic and therapeutic protocols: a scoping review

“…During the childhood of healthy patients, tooth exfoliation does not present any substantive complication; however, patients with IBDs have a greater risk of spontaneous and constant bleeding. 20 In fact, in some cases, primary tooth exfoliation or extraction leads to the diagnosis of an IBD. 21 It has been reported previously that teenagers with or without IBDs present similar oral problems (e.g.…”

“…It is important to highlight that some oral problems, such as caries or periodontal disease, are cumulative, beginning in the early stages of life. During the childhood of healthy patients, tooth exfoliation does not present any substantive complication; however, patients with IBDs have a greater risk of spontaneous and constant bleeding 20 . In fact, in some cases, primary tooth exfoliation or extraction leads to the diagnosis of an IBD 21 .…”