Dental Caries and Other Aspects of Oral Health That Impact Patients With Hemophilia

A recent study examined patterns of oral health in patients with hemophilia and identified a higher risk of developing dental caries with this condition. The study findings were reported in the European Journal of Dentistry.

The study was a cross-sectional analysis performed by researchers at Poznan University of Medical Sciences in Poznan, Poland. The study included clinical evaluations, in addition to a questionnaire. Patients in this study were adults between 18 and 70 years of age who were receiving care for congenital hemophilia A or B. A control group included volunteers lacking a bleeding or coagulation disorder.

In the clinical dental examination, there were several assessments of oral health. These included evaluations of oral hygiene, periodontal status, caries treatment index, and dental indicators related to incidence of caries. This last category included assessments of decayed, missing, and filled teeth (DMFT) and decayed, missing, and filled permanent teeth or surfaces (DMFS). Additional assessments considered impacts on oral health from factors related to hemophilia or its treatment.

A total of 77 patients with hemophilia were evaluated, and 50 individuals were included in the control group. Among patients with hemophilia, 83.17% had hemophilia A, and 16.88% had hemophilia B. On-demand therapy was used with 44.16%, and secondary prophylactic therapy was used with 55.84%. Hemophilia severity was mild in 16.88% of patients, moderate in 14.29%, and severe in 68.83%.

The prevalence of caries was greater in patients with hemophilia, compared with the control group. This was reflected in a higher DMFT score, which was 14 for the group with hemophilia, compared with 9 for the control group (P =.003), and a higher DMFS score (30 versus 15, respectively; P =.002). The Approximal Plaque Index score was also higher in patients with hemophilia (0.48), compared with the control group (0.29; P =.009).

Oral health in patients with hemophilia did not appear significantly impacted by type of therapy or type of hemophilia. Patients who were grouped by severity of hemophilia showed significant differences for debris index (P =.025) and simplified oral hygiene index (P =.042), but median scores for these indexes were highest among patients with hemophilia of moderate severity. Various dental health indicators were significantly worse in patients who were over 34 years of age, compared with younger patients.

Based on questionnaire responses, the group of patients with hemophilia showed significant differences in some aspects of oral health care, compared with the control group. A key difference was seen with professional teeth cleanings, which were reportedly less prevalent among patients with hemophilia than in the control group (P <.001).

The researchers concluded that the study showed a higher incidence of dental caries in patients with hemophilia, compared with the control group. The researchers also suggested that bleeding risk may lead to apprehension about some procedures, and that prophylaxis and appropriate health education should be introduced early into dental care for patients with coagulation disorders.

Reference

Czajkowska S, Rupa-Matysek J, Gil L, Surdacka A. Assessment of oral health and healthy habits in adult patients with congenital hemophilia. Eur J Dent. Published online May 2, 2022. doi:10.1055/s-0042-1743156