Table 3.63.
Guidelines for management of oral health care procedures in the haemophilias
| Procedure* | Haemophilia** | |||
|---|---|---|---|---|
| Mild | Moderate | Severe | ||
| LA |
Intraligamentary | – | – | – |
| Buccal infiltration | – | – | – | |
| Lingual infiltration | – | FR | FR | |
| Regional block | FR | FR | FR | |
| Non-surgical care without regional LA |
Prosthetics | – | – | – |
| Conservation | – | – | – | |
| Root canal therapy | – | – | FR | |
| Orthodontics | – | – | – | |
| Surgical care with or without LA | Scaling | ± T | T | FR + T |
| Trauma |
Soft tissue | – | FR | FR |
| Bone | FR | FR | FR | |
| Surgery | Soft tissue | FR + T | FR + T | FR + T |
| Periodontal | FR + T | FR + T | FR + T | |
| Exodontia | FR + T | FR + T | FR + T | |
| Dentoalveolar | FR + T | FR + T | FR + T | |
| Implant | FR + T | FR + T | FR + T | |
| Major | FR + T | FR + T | FR + T | |
LA = local anaesthesia. FR = Factor replacement. T = Tranexamic acid 5% mouthwash used qds for 5 days post-procedure.
*
If in doubt, consult haematologist.
**
Minimal requirements, assuming no additional bleeding tendency (liver disease etc).