Table 3.163.
Key considerations for dental management in Von Willebrand disease
| Management modifications* | Comments/possible complications | |
|---|---|---|
| Risk assessment | 3 | Haemorrhage |
| Appropriate dental care | 3 | DDAVP; factor VIII |
| Pain and anxiety control | ||
| – Local anaesthesia | 1 | Avoid regional blocks |
| – Conscious sedation | 2 | Avoid nitrous oxide |
| – General anaesthesia | 3/4 | Factor VIII |
| Patient access and positioning | ||
| – Access to dental office | 0 | |
| – Timing of treatment | 0 | |
| – Patient positioning | 0 | |
| Treatment modification | ||
| – Oral surgery | 3 | Bleeding |
| – Implantology | 3 | Bleeding |
| – Conservative/Endodontics | 1 | |
| – Fixed prosthetics | 1 | |
| – Removable prosthetics | 0 | |
| – Non-surgical periodontology | 3 | Bleeding |
| – Surgical periodontology | 3 | Bleeding |
| Hazardous and contraindicated drugs | 1 | Avoid NSAIDs |
*
0 = No special considerations. 1 = Caution advised. 2 = Specialised medical advice recommended in some cases. 3 = Specialised medical advice mandatory. 4 = Only to be performed in hospital environment. 5 = Should be avoided.