Safe Outpatient Dental Management of a Pediatric Patient With Mild Hemophilia A: A Case Report

Dental care in children with mild hemophilia A requires coordinated planning to prevent bleeding complications. An 11-year-old girl diagnosed recently with mild hemophilia A (factor VIII activity 46%) was referred for comprehensive dental care. Multidisciplinary planning with her pediatric hematologist was undertaken. One hour before multiple extractions (#55, #53, #65, #75 and a mesiodens), she received 1,000 IU of factor VIII. Extractions were completed using topical anesthesia for mobile primary teeth and limited lidocaine with epinephrine infiltration when needed, with local hemostasis achieved by gauze compression; no complications occurred. Subsequent restorative care included resin restorations (#21, #36, #12) and pit-and-fissure sealants (#46, #16, #26) during scheduled visits. The patient healed uneventfully and continued routine follow-up. In mild hemophilia A, individualized planning, pre-procedure factor replacement for invasive care, preference for infiltration techniques, and meticulous local hemostasis allow safe outpatient dental management.