Practical Recommendations for Treatment of Dental Patients with Congenital Bleeding Disorders during the Covid-19 Pandemic: A Narrative Review

Abstract

At the end of 2019, a new disease—COVID-19—was identified, and a few months later, the World Health Organization announced a pandemic. It is now known that SARS-CoV-2 is highly contagious and most confirmed infections are mild to moderate. The situation is particularly difficult for dentists due to the high risk of virus transmission in the dental surgery. Complications including, but not limited to, problems with the respiratory and cardiovascular systems have been reported in patients with SARS-CoV-2. Several changes in the coagulation system, such as lower platelet numbers or increased prothrombin time, as well as increased D-dimer and fibrinogen, were observed. This review is intended to systematize the knowledge on the treatment of patients with congenital bleeding disorders (CBD) during the SARS-CoV-2 pandemic. Extensive literature research was conducted into COVID-19 and the general medical and dental treatment of patients with CBD. Case studies, research results and recommendations of international societies were used in the study. The results of this research are presented in the form of recommendations for the treatment of patients with coagulopathies. It should be remembered that the impact of COVID-19 on the health condition of patients with CBD is unknown to date.

The Impact of the First Wave of the COVID-19 Pandemic on Providing Special Care Dentistry: A Survey for Dentists

“…Numerous guidelines have been published for providing dental care during the COVID-19 era [ 20 ]. Although most share common proposals, a number of the guidelines incorporate peculiarities directed at specific groups, such as immunocompromised individuals with cancer [ 21 ] and those with congenital bleeding disorders [ 22 ]. Many of these protocols are unrealistic, perhaps due to the lack of evidence-based research on their efficacy [ 20 ].…”

The Impact of the COVID-19 Pandemic on the Spectrum of Performed Dental Procedures

“…In addition, patients with systemic diseases should require special dental care, even during pandemic periods. For example, patients with congenital bleeding disorders are at risk for uncontrolled bleeding after oral procedures [ 35 ].…”

Social and Psychological Implication of New Normal Adaptation

“…However, there are more recommendations for health workers in dealing with COVID 19 patients because the number of patients is very global, almost evenly distributed in all regions. Including patients with certain diseases [22] of course it needs special attention. This means that even through online lectures, it is necessary to convey a message of truth about health information and if there are people who already have a history of triggering health problems, they should also be able to provide assistance and remind each other the importance of maintaining health.…”