Researchers compared procedural bleeding rates and systemic hemostatic treatment use before and after the introduction of a risk-based standardized treatment protocol for bleeding prevention in dental procedures, as published in Haemophilia.
The retrospective review of dental procedures was conducted in patients with hemophilia and various other inherited bleeding disorders, and it compared patient outcomes before and after the use of a standardized protocol. This protocol aimed to standardize the management of such patients and was created based on existing literature and multidisciplinary expert opinions. Tranexamic acid, factor replacement, and desmopressin were the mainstay of treatment used for the purpose of this study.
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Based on their risk of bleeding, dental procedures were classified using 2 classification systems: the Dental Bleeding Risk Assessment and Treatment Tool and a local classification.
There were 137 dental procedures conducted in 95 patients, and the team concluded that there was no statistically significant difference between the control and intervention groups. The introduction of the protocol, however, led to an increase in the administration of tranexamic acid, which might prove beneficial owing to the economic value and minimal risk of adverse effects of the drug.
The involvement of a multidisciplinary team in this study led to a very thorough understanding of the risk of bleeding associated with dental procedures, allowing researchers to come up with a holistic protocol that included patients with various inherited and acquired bleeding disorders in addition to hemophilia.
While the diverse patient population and rigorous approach to data collection in this study allow it to be compared to other published treatment guidelines and protocols, the team encourages further prospective research to identify safe and effective treatment modalities that would allow individualization of treatment and international standardization of care.
Champagne PA, Bourassa M, Desjardins MP, et al. Post-procedural bleeding rate and haemostatic treatment use for dental procedures before and after the implementation of a standardized protocol for people with inherited bleeding disorders. Haemophilia. Published online June 25, 2022. doi:10.1111/hae.14609