Haematology
Dental Management of Patients with Bleeding disorder (haemophilia/vWD)
Haematology coordination required before invasive care
Inherited bleeding disorders require factor/desmopressin cover and haematology planning before any invasive procedure.
Emergency vs routine management
If EMERGENCY — what to do
- • Contact the haemophilia centre BEFORE any invasive emergency treatment — factor replacement/DDAVP as directed.Ref: Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
- • Until cover is arranged: non-invasive pain relief (paracetamol); avoid NSAIDs and inferior alveolar nerve blocks.Ref: Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
- • Tranexamic acid (oral or 5% mouthwash) as adjunct.Ref: Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
If ROUTINE — what to do
- • Plan all invasive care with haematology; IANB requires factor cover.Ref: Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
- • Prefer infiltration / intraligamentary LA; intensive prevention.Ref: Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
Clinical precautions
- • Coordinate with haematology before surgery
- • Factor replacement / desmopressin / antifibrinolytics as advised
- • Local haemostatic measures
- • Avoid IDBs/regional blocks without cover
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | MODIFY / CAUTION Non-invasive care with caution |
| Supragingival scaling / polish | EMERGENCY / DEFER Haematology coordination required before invasive care |
| Deep scaling / subgingival RSD (subgingival calculus) | EMERGENCY / DEFER Haematology coordination required before invasive care |
| Root canal treatment | MODIFY / CAUTION Non-invasive care with caution |
| Simple extraction (1–3 teeth) | EMERGENCY / DEFER Haematology coordination required before invasive care |
| Surgical / bony extraction | EMERGENCY / DEFER Haematology coordination required before invasive care |
| Implant placement | EMERGENCY / DEFER Haematology coordination required before invasive care |
References
- Haemophilia / vWD — haematology-led dental care
- Srivastava A et al. WFH Guidelines for the Management of Hemophilia, 3rd ed. Haemophilia 2020;26(Suppl 6):1–158
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.