Patton LL. Bleeding and clotting disorders, 10th ed. Hamilton (ON): BC Decker; 2003
Meechan JG, Greenwood M. General medicine and surgery for dental practitioners Part 9: haematology and patients with bleeding problems. Br Dent J. 2003; 195:(6)305-310
London: British Dental Association, British Medical Association, Royal Pharmaceutical Society of Great Britain;
Ferrieri Giovanni B, Carmagnola Daniela, Strohmenger Laura Oral surgery in patients on anticoagulant treatment without therapy interruption. J Oral Maxillofac Surg. 2007; 65:1149-1154
Pasi KJ, Collins PW, Keeling DM Management of von Willebrand disease: a guideline from the UK Haemophilia Centre Doctors' Organization. Haemophilia. 2004; 10:218-231
Romney G, Glick M. An updated concept of coagulation with clinical implications. J Am Dent Assoc. 2009; 140:(5)567-574
Collins PW, Percy CL. Advances in the understanding of acquired haemophilia A: implications for clinical practice. Br J Haematol. 2010; 148:(2)183-194
Wahl MJ. Myths of dental surgery in patients receiving anticoagulant therapy. J Am Dent Assoc. 2000; 131:(1)77-81
Jover-Cerveró A, Poveda Roda R, Bagán JV, Jiménez Soriano Y. Dental treatment of patients with coagulation factor alterations: an update. Med Oral Patol Oral Cir Bucal. 2007; 12:(5)380-387
Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 1: Coagulopathies from systemic disease. Br Dent J. 2003; 195:(8)439-445
Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 2: Coagulopathies from drugs. Br Dent J. 2003; 195:(9)495-501
Dentists may encounter patients with various types of bleeding disorders in their daily practice. Initial recognition of such bleeding disorders and their possible systemic causes, as well as knowing when to refer those cases to secondary care, plays a crucial and important role in reducing potential complications and negative side-effects. This article will give an account of the most common bleeding disorders that dentists might find in their daily dental practice. This will be followed by another article that will cover the management of congenital and acquired disorders found in the dental practice.
Clinical Relevance: Bleeding disorders are occasionally encountered in patients in dental practice. Dentists must be knowledgeable about these disorders and be aware of the impact of such conditions on the management of their patients.
Article
In order to control haemostasis following an injury to a blood vessel, a series of events is initiated and these may be summarized as follows:
Bleeding disorders could affect any or many of these events and could be acquired or congenital in nature.
Platelet disorders in general could be classified as being quantitative or qualitative (which could be inherited, such as Bernard-Soulier disease and Glanzmann's Thrombasthenia, or acquired, like the altered platelet function after Aspirin or NSAIDs intake). They may present clinically with purpura, petechiae, mucosal bleeding, epistaxis and menorrhagia.
Clotting cascade disorders could be divided broadly into inherited disorders (like Haemophilia A & B, and Von Wllibrand's disease), or acquired disorders (like disseminated intravascular coagulation (DIC), liver disease and vitamin K deficiency).
Bleeding disorders and their systemic causes, if not recognized and dealt with prior to most invasive dental surgery, may have devastating and even life-threatening side-effects. It is, therefore, important that dentists and oral surgeons check their patients' medical and dental histories and give enough time to discuss them with the patients, making sure that these histories are kept up-to-date on a systematic and regular basis.
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