US researchers discovered that children with bleeding disorders such as hemophilia commonly have significant dental pathologies that lead to higher risks of morbidity, according to a study published in Haemophilia.

Children diagnosed with bleeding disorders in the US receive multidisciplinary care to prevent bleeding complications that can worsen their quality of life or survival. Through this approach, hemophilia treatment centers (HTCs) have managed to lower the risk of death by 40% in patients under their care, compared to patients not being treated at HTCs. 

Oral bleeding in patients diagnosed with bleeding disorders commonly occurs from physiological interruptions, poor oral hygiene, or trauma. Simple dental treatments can potentially result in a life-threatening bleeding episode. The risk for this happening is highest among patients who have developed neutralizing inhibitors to coagulation factors.

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“The objective of this study was to evaluate the dental habits, needs and oral health status of [pediatric] patients seen at the Haemophilia of Georgia Centre for Bleeding and Clotting Disorders of Emory, to identify predictive characteristics that indicate a higher risk for poor oral health,” Brown et al wrote. Understanding the percentage of patients at risk of oral bleeding disorders would allow HTCs to appropriately allocate their resources according to patients’ dental needs. 

Researchers recruited 226 pediatric patients from HTCs, with 64% having hemophilia A or B, 25% having von Willebrand disease, and 13% having other bleeding disorders. The patients were asked to fill in a 14-question survey and undergo an examination by dental professionals. 

The results revealed that 44% of patients do not brush their teeth twice a day, 27% do not have a dentist, and 15% report challenges with access to dental care. The oral screening exam that the patients underwent revealed that 89% of them had plaque accumulation, 37% had gingivitis, and 8% had lesions that were suggestive of dental caries. 

“In conclusion, this study is the first of its kind to evaluate dental health, dental habits and barriers to dental care in [pediatric] patients with bleeding disorders,” the research team wrote.

“Further evaluation of risk factors for poor dental health should be identified with further studies, especially when focusing on longitudinal care with a child’s primary dentist.”


Brown MC, Hastie E, Shumake C, Waters B, Sidonio RF Jr. Dental habits and oral health in children and adolescents with bleeding disorders: a single-institution cross-sectional studyHaemophilia. 2021;1-7. doi:10.1111/hae.14457