Comprehensive dental care for children with bleeding disorders--a dentist's perspective

Providing treatment to pediatric patients with bleeding disorders can present a challenge for the dentist. In the past, this group of patients may have avoided regular dental care, attending the dentist only in acute situations requiring immediate attention. Today, with the recent advances in medical management, patients with bleeding disorders can undergo comprehensive dental care. However, the dentist must have an understanding of the patient's specific coagulation defect, and use a team approach with the patient's physician and hematologist prior to undertaking any treatment. This paper reviews the key aspects of patient assessment and provides specific management protocols for all phases of dental treatment. Supported by a strong preventive program, the use of indicated replacement therapy where necessary, conservative treatment approaches, and the use of local hemostatic measures to control hemorrhage, most cases can be successfully managed. Thus, a valuable and once neglected service can be delivered in a safe and thorough manner.