This section of Step Out provides adults with information on oral and dental care. This information includes an overview of good oral and dental health habits, information about how to prevent mouth injuries, and dental treatment for people with blood or bleeding disorders.
This section of Dental Care will cover:
The Goal of Good Oral and Dental Care
Dental Care and Bleeding Disorders
Guarding Against Mouth Injuries
The Goal of Good Oral and Dental Care
Having a bleeding disorder does not mean dental problems are more common, but it means that if there are dental problems, bleeding complications can be more likely. Good oral and dental health begins with brushing, flossing and regular dental care from a dental provider who understands your bleeding disorder. Your dental provider should work together with you and your Hemophilia Treatment Center (HTC) or health care provider to ensure safe, appropriate care.
The goal of good oral and dental care is to keep not just the teeth healthy and clean but the gums, too. The gums (called gingiva), which are soft tissue, cover the bones surrounding the roots of the teeth. One of the early stages of gum disease (called periodontal disease) is gingivitis. Gingivitis is a swelling of the gums caused by bacteria. One of the first signs of gum disease is spontaneous bleeding.
Gum disease is a much more difficult problem for people with bleeding disorders because they will bleed longer. Treating the bleed with medicine or other treatment may temporarily stop the bleeding but not the underlying gum disease. To prevent gum disease, brush your teeth and floss regularly. Healthy gums do not generally bleed, even in a person with a bleeding disorder. You may see some bleeding, however, if you brush too hard. Do not stop the brushing or flossing routine if light bleeding occurs. If bleeding lasts longer than 20 minutes or stops and starts again, contact your Hemophilia Treatment Center (HTC) or health care provider
A consistent brushing and flossing routine can help prevent gum disease, maintain a healthy smile, and protect teeth for a lifetime!
Brushing and flossing are the best ways to keep teeth and gums healthy. They help prevent cavities and gum disease, like gingivitis, which can make gums red, sore, and bleed. To help make the job more inviting, have plenty of oral hygiene supplies on hand, such as flavored floss or plastic flossers and good-tasting toothpaste with fluoride. Remember to replace toothbrushes every three months.
Gums may bleed slightly when you first start flossing or if you have not flossed in a while. Plaque is the sticky film of bacteria that forms on teeth and gums. When plaque is removed, the gums will be healthier, and bleeding will lessen. Usually, this initial gum bleeding doesn't require factor replacement treatment. However, if bleeding continues for more than 20 minutes or stops and then starts again, call your Hemophilia Treatment Center (HTC) or dental provider.
Dental Care and Bleeding Disorders
People with bleeding disorders have the same dental issues as everyone else, but complications related to poor dental care are a little more serious, especially if surgery is needed. Be sure to schedule regular checkups and teeth cleanings. Your dental provider can identify problems early and reinforce healthy habits.
It is important to find a dental provider who knows about bleeding disorders and your overall care plan. When you find a dentist who you are comfortable with, connect them with your Hemophilia Treatment Center (HTC). If you cannot find a dental provider, contact your HTC. Your HTC usually has a dental provider they can recommend, or they may have one who is part of their comprehensive care team.
Here are some important facts to remember about dental care for a person with a bleeding disorder:
- Tell your dental provider if you are on prophylactic therapy and how you treat any bleeding episodes. Prophylaxis is a treatment regimen to prevent bleeds.
- Tell your dental provider about any changes in the treatment of your bleeding disorder
- If you are on prophylaxis, schedule dental visits on days when you receive factor replacement treatment
- Contact your dental provider and HTC if you have prolonged bleeding after a teeth cleaning
Treatment for Dental Procedures
- Contact your Hemophilia Treatment Center (HTC) or health care provider before any dental procedures. The HTC, dental provider, and oral surgeon can develop a pretreatment plan. Having a pretreatment plan before a dental procedure reduces the risk of prolonged bleeding after the procedure. They will work together to:
- Decide what medicine or treatment might be needed based on the bleeding disorder and the type of dental procedures planned
- Treat any mouth infections with antibiotics before doing any surgical procedure
- Bleeding may be controlled with special procedures and rinses
- If pain medication is needed, do not use any medicine like aspirin that increases bleeding
- Ask your dental provider or HTC team about a special diet after dental procedures, such as a tooth removal, to reduce bleeding
- Follow all steps outlined by the HTC, dental provider, and oral surgeon before any dental procedure
Guarding Against Mouth Injuries
Accidents, falls, and injuries to the mouth, gums, tongue, cheeks, and lips often cause bleeding. Usually, these bleeds are minor but can look alarming when the blood mixes with a large amount of saliva.
Here are some safety tips for people with a bleeding disorder:
- Always wear mouth guards when playing sports
- Wear mouth guards and night guards to avoid chipped teeth and cut lips
- Avoid getting a lip or tongue piercing. Oral piercings can cause health risks in people with bleeding disorders. They can cause bleeding, infection, nerve damage, gum damage, and can crack or chip teeth
- Avoid hot foods that can burn the tongue or the inside of the mouth or crusty foods if you have previously had bleeding in your mouth
- Never run with anything in your mouth—besides choking, you can hurt your cheeks, teeth, gums, or lips
If you have a mouth or tooth injury, contact your Hemophilia Treatment Center (HTC).
For more information about types of bleeds, please go to Identifying Different Types of Bleeds.