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Li Y, Liu G, Wu R, Yu G. Oral health status and oral habits of children and adolescents with hemophilia: a report from the children's hemophilia comprehensive care center of China. Eur J Pediatr 2024; 183:897-902. [PMID: 37934283 PMCID: PMC10912247 DOI: 10.1007/s00431-023-05270-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Revised: 09/22/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023]
Abstract
In recent years, the diagnosis and treatment of hemophilic children in China has significantly improved. However, oral health conditions, which affect quality of life, haven't received attention in this population. To explore the oral health status and oral hygiene of children and adolescents with hemophilia in the Children's Hemophilia Comprehensive Care Center of China. Dental and oral hygiene examinations were performed in children and adolescents with hemophilia who visited Beijing Children's Hospital. DMFT/dmft (decayed, missing, filled teeth in permanent and primary teeth) was assessed according to World Health Organization (WHO) criteria. The simplified oral hygiene index (OHI-S) was used to evaluate the oral hygiene condition of the subjects. Questionnaires were completed by their parents. SPSS 21.0 was used for statistical analysis. A total of 114 children and adolescents were enrolled. The caries prevalence was 57.4%, 72.2% and 41.2% in primary, mixed and permanent dentitions respectively. The filling rates were 14.4%, 13.9%, and 11.4%, respectively, and the OHI-S scores of the three dentition groups were 1.49 ± 0.46, 1.57 ± 0.43, and 1.76 ± 0.46, respectively. A total of 103 valid questionnaires were collected. Sixty-nine children (67%) didn't brushed their teeth 2 times a day. Nearly half of the parents knew little about fluoride toothpaste. Multiple linear regression analysis revealed that brushing teeth with the help of parents had a significant positive impact on OHI-S. Conclusion: Dental health was unsatisfactory among hemophilic children and adolescents. The caries filling rates were low. Patients and their parents did not give much attention to oral health. What is Known: • Caries and gingivitis are the two main oral diseases that affect children with hemophilia. • However, the oral health conditions of children and adolescents with hemophilia have not received much attention in China. What is New: • This is the first study concentrating on the dental health of children with hemophilia in China. • Dental health was unsatisfactory among children and adolescents with hemophilia in China.
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Affiliation(s)
- Yue Li
- Department of Stomatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nanlishi Road 56, Xicheng District, Beijing, 100045, China
| | - Guoqing Liu
- Department of Hematology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Runhui Wu
- Department of Hematology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, 100045, China
| | - Guoxia Yu
- Department of Stomatology, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Nanlishi Road 56, Xicheng District, Beijing, 100045, China.
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Mulders G, van Verseveld H, van der Geer J, Wolvius E, Leebeek F. The state of oral health in patients with haemophilia in the Netherlands. Haemophilia 2023; 29:466-478. [PMID: 36626277 DOI: 10.1111/hae.14719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 10/20/2022] [Accepted: 10/20/2022] [Indexed: 01/11/2023]
Abstract
INTRODUCTION Previous studies show contradictory outcomes regarding dental, gingival and periodontal status in persons with haemophilia (PWH) compared to healthy controls. PWH may experience disease-specific barriers to access dental care due to their bleeding tendency, which may lead to delays in oral care and severe dental problems. AIM To determine the current subjective and objective oral health status in adult PWH. METHODS Randomly selected PWH of the Erasmus MC Haemophilia Treatment Center (HTC), Rotterdam, the Netherlands, were invited to participate. Data was collected using the Oral Health Impact Profile (OHIP-14NL) and personal interviews. A dentist used the DMFT index, the Dutch Periodontal Screening index (DPSI), plaque and bleeding index to score the dental status. RESULTS Forty-eight adult PWH were included in this study, 20 mild, 15 moderate-severe and 13 severe haemophilia with a mean age of 44.7. PWH scored low on the OHIP-14 questionnaire (median total score 1.0; IQR .0-3.0), indicating a high self-rating oral health status. The number of bleeding events, bleeding- and plaque index score was not statistically significant between patients with mild, moderate or severe haemophilia. The mean number of decayed, missing, and filled teeth (DMFT-score) was significantly lower in the group of patients with severe haemophilia (median 2.0) compared to mild haemophilia (median 16.0) (p = .04). Twenty-five patients (52.1%) reported to have encountered bleeding problems during or after dental interventions during their lifetime. CONCLUSION Dutch adult PWH A/B have good dental status and oral health status.
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Affiliation(s)
- Greta Mulders
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Hanneke van Verseveld
- Department of Oral and Maxillofacial Surgery and Special Dental, Care, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Joyce van der Geer
- Department of Oral and Maxillofacial Surgery and Special Dental, Care, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Eppo Wolvius
- Department of Oral and Maxillofacial Surgery and Special Dental, Care, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Frank Leebeek
- Department of Hematology, Erasmus MC, Erasmus University Medical Center, Rotterdam, The Netherlands
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Sharma S, Shahi AK, Chandra S, Abdul NS, Singh B, Singh R, Shivakumar GC. State of Dental Health and Management Needs of Young Hemophilic Patients: A Case-control Study. Int J Clin Pediatr Dent 2023; 16:380-387. [PMID: 37519953 PMCID: PMC10373760 DOI: 10.5005/jp-journals-10005-2523] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023] Open
Abstract
Background In particular, when it comes to systemic diseases like hemophilia, good dental health is crucial to a person's overall health and wellness. Through the means of this study, we aim to assess the prevalence of various dental anomalies in children suffering from hemophilia in comparison to healthy children and assess their treatment needs. Materials and methods This was a descriptive, case-control study with 400 subjects, 200 each in the study (hemophilic) and control (nonhemophilic) groups. The subjects' ages ranged from 5 to 15 years. Utilizing the oral hygiene index-simplified (OHI-S), the state of oral hygiene was documented (OHI-S). Using decaying extracted filled tooth (DEFT) and decayed, missing, and filled tooth (DMFT) for the primary and permanent dentition, respectively, teeth afflicted by dental caries and teeth restored/extracted as a result of dental caries were assessed. Statistical Package for the Social Sciences (SPSS) software (version 27.0) was used for statistical analysis. Results Hemophilic people had a considerably greater incidence of dental caries. Furthermore, even though their DMFT/DEFT and OHI-S scores were barely poorer than those of healthy people, children with hemophilia had a significantly larger percentage of dental treatment needs across all age categories than the other group. Conclusion The percentage of hemophilic children who needed dental treatment across different age groups was significantly higher than the other group, which supports our observations that the dental health status of hemophilic children was poor and treatment requirement was high among them as well. This is true even though the DMFT/DEFT scores and OHI-S scores in hemophilic children were only slightly worse than in healthy individuals. How to cite this article Sharma S, Shahi AK, Chandra S, et al. State of Dental Health and Management needs of Young Hemophilic Patients: A Case-control Study. Int J Clin Pediatr Dent 2023;16(2):380-387.
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Affiliation(s)
- Swati Sharma
- Department of Pedodontics & Preventive Dentistry, Dental College, RIMS, Ranchi, Jharkhand, India
| | - Ajoy K Shahi
- Department of Pedodontics & Preventive Dentistry, Dental College, RIMS, Ranchi, Jharkhand, India
| | - Subhash Chandra
- Department of Orthodontics & Dento-facial Orthopaedics, Dental College, RIMS, Ranchi, Jharkhand, India
| | - Nishath S Abdul
- Faculty of Oral & Maxillofacial Surgery & Diagnostic Sciences, College of Dentistry, Riyadh Elm University, Riyadh, Saudi Arabia
| | - Bishnupati Singh
- Department of Prosthodontics, Dental College, RIMS, Ranchi, Jharkhand, India
| | - Rohit Singh
- Department of Pedodontics and Preventive Dentistry, Vananchal Dental College & Hospital, Garhwa, Jharkhand, India
| | - Ganiga C Shivakumar
- Department of Oral Medicine & Radiology, People's College of Dental Science and Research Center, People's University, Bhopal, Madhya Pradesh, India
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George AM, Mayya A, Mayya A, Iszham AB, Rafi NHBM, Marius R, Mayya SS. Knowledge and Awareness regarding Dental Management of Hemophilic Patients among Students of a Malaysian University: A Cross-Sectional Study. Open Dent J 2022. [DOI: 10.2174/18742106-v16-e2205260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Improper management of bleeding disorders in the dental setting can lead to complications that can endanger the lives of such patients.
Objective:
This study aimed to assess the knowledge and awareness of dental management of hemophilia among undergraduate students of a Malaysian university.
Methodology:
A cross-sectional survey was conducted in the year 2018-2019 to collect the data. A 23-item questionnaire developed and validated by the authors was used to collect data on the knowledge and awareness regarding dental management of hemophilia patients. A total of 216 dental students participated in this research. Unpaired t-test and one-way ANOVA were used to compare the knowledge score between gender and academic year.
Results:
Only 21% of the participants were confident in treating a hemophilia patient. About 97% of the participants believed that the dental curriculum must be modified to emphasize the dental management of bleeding disorders. The overall mean of the knowledge score was 47.38% and awareness was 73.7% regarding the management of patients with hemophilia.
Conclusion:
The study revealed significant scope for improvement in the dental students' knowledge, which can be achieved by modifying the dental curriculum suitably to provide more emphasis on the management of bleeding disorders.
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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 2022; 17:161-172. [PMID: 35500597 PMCID: PMC9949933 DOI: 10.1055/s-0042-1743156] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
OBJECTIVES The objective of our study was to assess the current knowledge, the oral health status, and the pro-health needs of patients with hemophilia. MATERIALS AND METHODS The study included 77 patients with known hemophilia. The study included the assessment of dental indicators related to caries incidence (decayed, missing, and filled teeth [DMFT] and decayed, missing, and filled permanent teeth or surfaces [DMFS]), caries treatment (treatment index), oral hygiene status (Approximal Plaque Index [API] and simplified oral hygiene index [OHI-S]), and periodontal status (bleeding on probing [BoP]). A questionnaire addressed symptoms of hemorrhagic diathesis and health-promoting habits. The influence of routine management ("on-demand" vs. prophylactic therapy), type of hemophilia (A, B), and severity of clotting factor deficiency (mild, moderate, or severe) on oral health was assessed. STATISTICAL ANALYSIS The tests used in the study were Shapiro-Wilk, Mann-Whitney, Kruskal-Wallis, and Dunn's tests. The level of significance was set at p < 0.05. RESULTS Patients with hemophilia showed a higher prevalence of caries compared with patients without hemorrhagic diathesis (DMFT 14 and 9, and DMFS 30 and 15, respectively), and they also presented a higher bleeding index value during probing and worse effectiveness of hygienic interdental procedures. The type of therapy and secondary prophylaxis used and the type and severity of hemophilia did not affect the oral health status. CONCLUSIONS Patients with hemophilia have an increased risk of developing dental caries. Undertaking educational activities related to the prevention of oral diseases is necessary to improve oral health.
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Affiliation(s)
- Sylwia Czajkowska
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland,Address for correspondence Sylwia Czajkowska, DMD Department of Conservative Dentistry and Endodontics, Poznan University of Medical SciencesBukowska 70, Poznań 60-356Poland
| | - Joanna Rupa-Matysek
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Lidia Gil
- Department of Hematology and Bone Marrow Transplantation, Poznan University of Medical Sciences, Poznan, Poland
| | - Anna Surdacka
- Department of Conservative Dentistry and Endodontics, Poznan University of Medical Sciences, Poznan, Poland
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Frusca do Monte CM, da Silva LT, da Silva VC, Almeida GS, Lorenzato CS, Menezes JVNB, Fraiz FC, Torres-Pereira CC. Access to dental care for patients with inherited bleeding and hemoglobin disorders. SPECIAL CARE IN DENTISTRY 2022; 42:509-515. [PMID: 35122672 DOI: 10.1111/scd.12701] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 12/16/2021] [Accepted: 01/21/2022] [Indexed: 11/30/2022]
Abstract
AIM To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD). METHODS Patients with IBD and HbD were invited to participate in this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co-variables (p < .05). RESULTS The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio [PR] = 1.021; 95% confidence interval [CI] = 1.010-1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291-0.990). CONCLUSION Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.
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Silva LTD, Souza JFD, Wambier LM, Menezes JVNB, Torres-Pereira CDC, Fraiz FC. Can Hemophilia Impact on the Oral Health Conditions of Children and Adolescents? A Systematic Review and Metanalysis. PESQUISA BRASILEIRA EM ODONTOPEDIATRIA E CLÍNICA INTEGRADA 2022. [DOI: 10.1590/pboci.2022.053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
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van Dijk WEM, van Es RJJ, Correa MEP, Schutgens REG, van Galen KPM. Dentoalveolar Procedures in Immune Thrombocytopenia; Systematic Review and an Institutional Guideline. TH OPEN 2021; 5:e489-e502. [PMID: 34805736 PMCID: PMC8595053 DOI: 10.1055/a-1641-7770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 09/07/2021] [Indexed: 11/10/2022] Open
Abstract
Background
Dentoalveolar procedures in immune thrombocytopenia (ITP) pose a risk of bleeding due to thrombocytopenia and infection due to immunosuppressive treatments. We aimed to systematically review the safety and management of dentoalveolar procedures in ITP patients to create practical recommendations.
Methods
PubMed, Embase, Cochrane, and Cinahl were searched for original studies on dentoalveolar procedures in primary ITP patients. We recorded bleeding- and infection-related outcomes and therapeutic strategies. Clinically relevant bleeding was defined as needing medical attention.
Results
Seventeen articles were included, of which 12 case reports/series. Overall, the quality of the available evidence was poor. Outcomes and administered therapies (including hemostatic therapies and prophylactic antibiotics) were not systematically reported. At least 73 dentoalveolar procedures in 49 ITP patients were described. The range of the preoperative platelet count was 2 to 412 × 10
9
/L. Two clinically relevant bleedings (2%) were reported in the same patient of which one was life-threatening. Strategies used to minimize the risk of bleeding were heterogeneous and included therapies to increase platelet count, antifibrinolytics, local measures, and minimally invasive techniques. Reports on the occurrence of bleedings due to anesthetics or infection were lacking.
Conclusion
Based on alarmingly limited data, clinically relevant bleedings and infections after dentoalveolar procedures in ITP patients seem rare. Awaiting prospective and controlled studies to further evaluate these risks and the efficacy of therapeutic interventions, we provided our institutional guideline to guide the management of dentoalveolar procedures in ITP patients.
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Affiliation(s)
- Wobke E M van Dijk
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Robert J J van Es
- Department of Oral and Maxillofacial Surgery, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maria E P Correa
- Oral Medicine Ambulatory, Hematology and Hemotherapy Center, University of Campinas, Campinas, Sao Paulo, Brazil
| | - Roger E G Schutgens
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Karin P M van Galen
- Center for Benign Hematology, Thrombosis and Hemostasis, Van Creveldkliniek, University Medical Center Utrecht, Utrecht, The Netherlands
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Kanjani V, Annigeri RG, Hanagavadi S, Manjunath MR. Comparative analysis of oral health and treatment necessities in hemophilia individuals of Davangere population - A case control study. J Family Med Prim Care 2020; 9:4774-4777. [PMID: 33209799 PMCID: PMC7652167 DOI: 10.4103/jfmpc.jfmpc_413_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2020] [Revised: 04/25/2020] [Accepted: 04/13/2020] [Indexed: 11/29/2022] Open
Abstract
Background: The integrated approach towards the oral care of individuals with special needs requires proper motivation and prophylactic guidance by primary health care professionals, including musculoskeletal support to psychological therapy. In developing countries like India, oral care is not of primary importance as oral hygiene practices are less performed by compromised individuals suffering from hemophilia. Here, primary health care professionals play a significant role. The present study was commenced to evaluate oral health and treatment necessities in hemophilic individuals of Davangere population, Karnataka. Objective: The present study was conducted to assess and compare the oral hygiene, dentition status, and treatment needs of individuals with hemophilia. Methods: Simplified Oral Hygiene Index (OHI-S), decayed, missed, filled tooth (DMFT) indices and treatment needs in 50 hemophiliac patients registered at Karnataka hemophilia society were evaluated along with an Oral health-related quality of life (OHR-QoL) questionnaire. They were matched with healthy controls of the same age and gender. The data was analyzed using t test and Chi square test. Results: The oral hygiene was fair in both hemophilic and healthy individuals with a mean value of 1.82 ± 0.79 and 1.83 ± 0.73, respectively. All the parameters such as OHIS, DMFT indices, and teatment needs were not statistically significant. The spontaneous oral bleeding was the only significant factor in OHR-Qol questionnaire. Conclusion: The present study concluded that oral hygiene, dental caries prevalence, and treatment needs were similar in both hemophiliac and control groups. With proper guidance, motivation, and preventive care by primary health care professionals, it was relatively easy for individuals with congenital blood disorder (CBD) to maintain oral health-related quality of life in Davangere population, Karnataka.
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Affiliation(s)
- Varsha Kanjani
- Department of Oral Medicine and Radiology, Vyas Dental College and Hospital, Jodhpur, Rajasthan, India
| | - Rajeshwari G Annigeri
- Department of Oral Medicine and Radiology, College of Dental Sciences, Davangere, Karnataka, India
| | - Suresh Hanagavadi
- Department of Pathology, J. J. M. Medical College, Davangere, Karnataka, India
| | - M R Manjunath
- Department of Oral Medicine and Radiology, College of Dental Sciences, Davangere, Karnataka, India
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Reddy KS, Reddy NV, Niharika P, Reddy MA, Danaeswari V, Noorjahan MD. Oral Health Status and Treatment Needs among Hemophilic Children in Hyderabad, Telangana, India. Int J Clin Pediatr Dent 2019; 12:30-32. [PMID: 31496568 PMCID: PMC6710940 DOI: 10.5005/jp-journals-10005-1585] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
AIMS AND OBJECTIVES The aim of this study is to evaluate and compare the dental caries stratus and treatment needs of hemophilic children with that of healthy and normal children. MATERIALS AND METHODS A descriptive cross-sectional study was conducted on 60 subjects with age ranging from 7-16 years attending and registering their names, residential address, parental occupation, and other criteria in Hemophilic Society at the Telangana state. The oral hygiene status was recorded by using oral hygiene index-simplified (OHI-S). Teeth affected by dental caries and teeth restored/extracted as sequale of dental caries were assessed using decayed, missed, filled tooth (DEFT) and DMFT for primary and permanent dentition, respectively. STATISTICAL ANALYSIS Data were analyzed by means of SPSS, version 21.0, and the Chi-square test and the Kruskal-Wallis test. RESULTS The mean oral hygiene index simplified scores were 1.28 in 7-9 years and 1.87 in 13-16 years, respectively. The mean DMFT + DEFT of 7-9 years was 4.76 and for 13-16 years was 3.11 highest mean DMFT + DEFT 4.76 was recorded in the 7-9 years age group. CONCLUSION The present study showed that oral hygiene status of hemophilic children was poor and treatment requirement was high among hemophilic children. The overall prevalence of dental caries was 73.3% and the treatment needs were 93.90%. HOW TO CITE THIS ARTICLE Reddy KS, Reddy NV, et al. Oral Health Status and Treatment Needs among Hemophilic Children in Hyderabad, Telangana, India. Int J Clin Pediatr Dent 2019;12(1):30-32.
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Affiliation(s)
- Kola Srikanth Reddy
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
| | - N Venugopal Reddy
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
| | - P Niharika
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
| | - M Ajay Reddy
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
| | - V Danaeswari
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
| | - MD Noorjahan
- Department of Pedodontics and Preventive Dentistry, Army College of Dental Science, Hyderabad, Telangana, India
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Kumar M, Pai KM, Kurien A, Vineetha R. Oral hygiene and dentition status in children and adults with hemophilia: A case-control study. SPECIAL CARE IN DENTISTRY 2018; 38:391-394. [PMID: 30256429 DOI: 10.1111/scd.12324] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Revised: 07/04/2018] [Accepted: 08/09/2018] [Indexed: 12/01/2022]
Abstract
BACKGROUND & OBJECTIVES People with hemophilia constitute a significant proportion of the population and an oral health care professional faces a considerable challenge while treating them. This study aimed to assess the oral health and dentition status as well as fear of dental treatment in patients with hemophilia and compare it with age-matched healthy subjects. PATIENTS & METHODS This single-center, case-control cross-sectional study was performed on 100 subjects with hemophilia and 100 age-matched healthy controls. Oral health and dentition status was recorded for all the subjects and scored using the simplified oral hygiene index (OHI-S), plaque index, and the dmft/DMFT index. RESULTS There were a total of 41 children and 59 adults in the hemophilia group and 36 children and 64 adults in the healthy group. When compared to healthy subjects it was observed that individuals with hemophilia had higher debris and calculus scores which was indicative of poor orodental status. There was no significant difference observed in the DMFT scores among the study groups. INTERPRETATION & CONCLUSIONS The oral hygiene of the hemophilics was poorer when compared to the healthy controls. The findings highlight the need for establishing interdisciplinary care for such individuals.
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Affiliation(s)
- Mathangi Kumar
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Keerthilatha M Pai
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Annamma Kurien
- Melaka Manipal Medical College, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
| | - Ravindranath Vineetha
- Department of Oral Medicine and Radiology, Manipal College of Dental Sciences, Manipal Academy of Higher Education, Manipal 576104, Karnataka, India
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Abstract
Children with hemophilia (A or B) are at risk for bleeding episodes, which rank from mild mucosal/soft tissues bleeding to life-threatening hemorrhages. This report describes the dental/medical management provided to an 8.10-year-old patient suffering from uncontrolled bleeding after a surgical procedure to expose both permanent upper central incisors, in which hemophilia was a pure incidental finding. Additionally, diverse precautions to be considered during the dental clinical treatment of hemophilic children are discussed.
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Evangelista LM, Lima CCB, Idalino RCL, Lima MDM, Moura LFAD. Oral health in children and adolescents with haemophilia. Haemophilia 2015; 21:778-83. [DOI: 10.1111/hae.12717] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/08/2015] [Indexed: 11/29/2022]
Affiliation(s)
| | | | - R. C. L. Idalino
- Informatic and Statistic Department; Federal University of Piauí; Teresina Piauí Brazil
| | - M. D. M. Lima
- Postgraduate Program in Dentistry and Postgraduate Program in Health Sciences; Federal University of Piauí; Teresina Piauí Brazil
| | - L. F. A. D. Moura
- Postgraduate Program in Dentistry and Postgraduate Program in Health Sciences; Federal University of Piauí; Teresina Piauí Brazil
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14
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Othman NAA, Sockalingam SNMP, Mahyuddin A. Oral health status in children and adolescents with haemophilia. Haemophilia 2015; 21:605-11. [DOI: 10.1111/hae.12657] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/21/2015] [Indexed: 11/28/2022]
Affiliation(s)
- N. A. A. Othman
- Department of Paediatric Dentistry; Hospital Sultanah Bahiyah; Alor Setar Kedah, Malaysia
| | - S. N. M. P. Sockalingam
- Unit of Paediatric Dentistry; Department of Operative Dentistry; Faculty of Dentistry; Universiti Kebangsaan Malaysia Kuala Lumpur, Malaysia
| | - A. Mahyuddin
- Unit of Paediatric Dentistry; Department of Operative Dentistry; Faculty of Dentistry; Universiti Kebangsaan Malaysia Kuala Lumpur, Malaysia
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Do hemophiliacs have a higher risk for dental caries than the general population? MEDICINA-LITHUANIA 2015; 51:46-56. [PMID: 25744775 DOI: 10.1016/j.medici.2015.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2014] [Accepted: 01/06/2015] [Indexed: 11/20/2022]
Abstract
OBJECTIVE The aim of this study was to examine if patients with hemophilia were at increased risk for dental decay as compared to the general population. MATERIALS AND METHODS Census sampling was used in this case-control study to recruit cases (patients with hemophilia) and a control group individuals recruited randomly from the general population, which were matched with cases based on gender, age and place of residence. Clinical examinations included dental health and salivary assessments (flow rate, buffer capacity, caries-associated bacteria) and a structured questionnaire which inquired about socioeconomic status and dental health-related behaviors. RESULTS In the deciduous dentition, the overall caries experience (dmf) differed statistically significantly (P=0.003) between the hemophiliacs (2.6±2.6) and their matched healthy controls (6.1±2.5). Bivariate analyses did not reveal significant differences between cases and controls regarding salivary functions, except that higher bacteriological counts were found in healthy controls in deciduous dentitions than in patients with hemophilia (P=0.019). Children without hemophilia were from higher socioeconomic status families than hemophiliacs (P=0.004), but such differences were not found for adults (P=0.090). When compared to healthy adults, adult hemophiliacs had more gum bleeding at rest (P<0.001) as well as during their tooth brushing (P=0.007) and they also consumed more soft drinks than controls (P=0.025). CONCLUSIONS Better dental health was observed in children with hemophilia as compared to children without it. There were no differences in dental health between adult hemophiliacs and healthy controls from the general population. None of the linear multiple regression models confirmed hemophilia to be an additional caries risk when it was controlled for other caries determinants.
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Nuvvula S, Gaddam KR, Kamatham R. Efficacy of tranexamic acid mouthwash as an alternative for factor replacement in gingival bleeding during dental scaling in cases of hemophilia: A randomized clinical trial. Contemp Clin Dent 2014; 5:49-53. [PMID: 24808695 PMCID: PMC4012117 DOI: 10.4103/0976-237x.128663] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Objective: The objective of the following study is to evaluate freshly prepared tranexamic acid mouth wash (FTAMW) as an alternative to factor replacement therapy (FRT) in controlling gingival bleeding in hemophiliacs during dental scaling. Materials and Methods: Experimental treatment regime (ETR) involved saline transfusion followed by FTAMW and the control treatment regime (CTR) involved FRT followed by placebo mouthwash. A total of 22 hemophiliacs randomly received dental scaling under either CTR or ETR at two different visits, following a split mouth design. They were instructed to use the rendered mouthwash 4 times a day for 5 days and record the mouthwash usage and bleeding episodes in a logbook. The difference in the bleeding episodes was analyzed using Chi-square test with the level of significance predetermined at 0.05. Results: Totally 19 patients completed the study. Seven patients reported no bleeding either in ETR or CTR; five patients noticed bleeding in CTR, but not in ETR. Three patients noticed bleeding in ETR, but not in CTR. Patients reported ease in usage and cost-effectiveness of ETR. Conclusion: FTAMW was found to be an effective alternative to FRT in controlling gingival hemorrhage in hemophiliacs during dental scaling.
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Affiliation(s)
- Sivakumar Nuvvula
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Kumar Raja Gaddam
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
| | - Rekhalakshmi Kamatham
- Department of Pedodontics and Preventive Dentistry, Narayana Dental College and Hospital, Nellore, Andhra Pradesh, India
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Rodrigues LV, Moreira MDSC, de Oliveira CR, de Medeiros JJ, Lima EDA, Valença AMG. Tooth loss and associated factors in patients with coagulopathies in the State of Paraíba, Brazil. Rev Bras Hematol Hemoter 2013; 35:319-24. [PMID: 24255614 PMCID: PMC3832311 DOI: 10.5581/1516-8484.20130097] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2012] [Accepted: 01/08/2013] [Indexed: 11/27/2022] Open
Abstract
Background The most common and best known hereditary coagulopathies are hemophilia A and B
followed by von Willebrand Disease. Objective This study aimed to estimate the prevalence of tooth loss and investigate its
association with demographic and socioeconomic data, as well as to discuss
self-reported oral morbidity and use of health services by patients with
coagulopathies treated in blood centers in Paraíba, Brazil. Methods This was a quantitative cross-sectional epidemiological survey. Data was collected
in the period from October 2011 to July 2012 by clinical examination and by
assessing interviews using a semi-structured questionnaire. The findings were
analyzed by descriptive and inferential statistics with the level of significance
(α) being set at 10%. Results One hundred and six, predominantly male (88.8%), patients with coagulopathies were
evaluated. The ages ranged from one to 59 years. Most patients were of mixed race
(61.3%), most reported family incomes between R$ 501.00 and R$ 1500.00 (49.1%),
and most had not completed elementary school (37.1%). Hemophilia A was found in
76.4% of the cases. The prevalence of dental caries among individuals was 50.0%
predominantly in the 13- to 19-year-old age range (66.7%). As regards to tooth
loss, teeth were missing in 35.1% of the study participants. Conclusion Tooth loss is high in this population. Males with severe hemophilia A, those who
use fluoride and have a good or very good perception about their last dental
appointment have a reduced chance of losing their teeth.
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Zaliuniene R, Aleksejuniene J, Peciuliene V, Brukiene V. Dental health and disease in patients with haemophilia - a case-control study. Haemophilia 2013; 20:e194-8. [DOI: 10.1111/hae.12325] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/22/2013] [Indexed: 11/30/2022]
Affiliation(s)
- R. Zaliuniene
- Faculty of Medicine; Institute of Dentistry; Vilnius University; Vilnius Lithuania
| | - J. Aleksejuniene
- Faculty of Dentistry; Division of Preventive and Community Dentistry; University of British Columbia; Vancouver BC Canada
| | - V. Peciuliene
- Faculty of Medicine; Institute of Dentistry; Vilnius University; Vilnius Lithuania
| | - V. Brukiene
- Faculty of Medicine; Institute of Dentistry; Vilnius University; Vilnius Lithuania
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Rajantie H, Alapulli H, Mäkipernaa A, Ranta S. Oral health care in children with haemophilia in Helsinki, Finland. Eur Arch Paediatr Dent 2013; 14:339-43. [PMID: 24068491 DOI: 10.1007/s40368-013-0090-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2012] [Accepted: 02/13/2013] [Indexed: 12/01/2022]
Abstract
BACKGROUND The bleeding tendency and fear of bleeds may have a negative effect on preventive dental care of patients with haemophilia both at home and at dental appointments. AIM To describe the clinical practice of dental care in children with haemophilia in Helsinki, Finland. METHODS This study evaluated retrospectively the medical records of 28 paediatric patients with haemophilia (aged 5.3-17.4 years) from dental visits during 2009-2010. Decayed, missing and filled teeth in the primary (dmft) and permanent dentition (DMFT), Community Periodontal Index (CPI), signs of developmental dental defects in enamel and the number of preventive and restorative procedures were gathered. Dmft + DMFT scores were compared with those of 17,079 non-haemophiliac boys. The Mann-Whitney U-test was used to compare the data between the groups of different severity of haemophilia. RESULTS The median number of dental visits per patient was three (range 1-11). Twenty-two patients (79 %) had dmft + DMFT-scores within the 95 % reference range for age. None of the children had a CPI >2. Twelve (43 %) patients had developmental enamel defects. Half had received restorative dental care and three out of four preventive procedures. CONCLUSIONS Dental care during hospital visits in children with haemophilia may enhance confidence in the preventive dental care and help minimise bleeding during dental procedures.
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Affiliation(s)
- H Rajantie
- Institute of Dentistry, University of Helsinki, Helsinki, Finland
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Castellanos-Cosano L, Machuca-Portillo G, Sánchez-Domínguez B, Torrés-Lagares D, López-López J, Segura-Egea JJ. High prevalence of radiolucent periapical lesions amongst patients with inherited coagulation disorders. Haemophilia 2013; 19:e110-5. [DOI: 10.1111/hae.12089] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2012] [Indexed: 02/07/2023]
Affiliation(s)
- L. Castellanos-Cosano
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | - G. Machuca-Portillo
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | | | - D. Torrés-Lagares
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
| | - J. López-López
- Department of Odontostomatology, School of Dentistry; University of Barcelona; Barcelona; Spain
| | - J. J. Segura-Egea
- Department of Stomatology, School of Dentistry; University of Sevilla; Sevilla; Spain
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Percival T, Aylett SE, Pool F, Bloch-Zupan A, Roberts GJ, Lucas VS. Oral health of children with intractable epilepsy attending the UK National Centre for Young People with Epilepsy. Eur Arch Paediatr Dent 2012; 10:19-24. [DOI: 10.1007/bf03262662] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Pereira CM, Pires FR, Corrêa MEP, di Hipólito Júnior O, Almeida OPD. Candida in saliva of Brazilian hemophilic patients. J Appl Oral Sci 2012; 12:301-6. [PMID: 20976401 DOI: 10.1590/s1678-77572004000400009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2004] [Accepted: 05/19/2004] [Indexed: 11/22/2022] Open
Abstract
Hemophilia is a common hereditary hemorrhagic disorder, however little is known about the oral microflora of hemophilic patients. The aim of this study was to quantify the Candida and identify its species in non-stimulated saliva of hemophilic patients, and consider its relationship with clinical factors influencing Candida carriage. This study comprised evaluation of 86 hemophilic patients of the Hematology Center/UNICAMP and 43 healthy subjects as controls. All patients were submitted to anamnesis, intraoral examination and unstimulated saliva collection. Candida counts and species identification were performed in salivary samples. Candida was present in 64% of the hemophilic patients and in 44% of the healthy controls. C. albicans represented 65% and 68% of the isolated species, in hemophiliacs and control group respectively, and C. tropicalis was the second most common species in both groups. These results indicate that hemophilic patients carry Candida more frequently and in higher counts than healthy controls, independently of oral clinical parameter considered, as viral infections, complete dentures, transfusions of hemoderivatives, and salivary flow.
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Affiliation(s)
- Rolf C. R. Ljung
- Lund University, Departments of Paediatrics and Malmö Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö; Sweden
| | - Karin Knobe
- Lund University, Departments of Paediatrics and Malmö Centre for Thrombosis and Haemostasis; Skåne University Hospital; Malmö; Sweden
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Ziebolz D, Stühmer C, Hornecker E, Zapf A, Mausberg RF, Chenot JF. Oral health in adult patients with congenital coagulation disorders - a case control study. Haemophilia 2011; 17:527-31. [PMID: 21371183 DOI: 10.1111/j.1365-2516.2010.02443.x] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- D Ziebolz
- Department of Preventive Dentistry, Periodontology and Cariology, University Medical Center Goettingen, Germany.
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Carcao MD, Seary ME, Casas M, Winter L, Stain AM, Judd P. Dental disease in type 3 Von Willebrand disease: a neglected problem. Haemophilia 2010; 16:943-8. [PMID: 20565545 DOI: 10.1111/j.1365-2516.2010.02344.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Type 3 Von Willebrand disease (VWD) is a rare, severe, autosomal recessive bleeding disorder. In our institution, we follow 17 children with type 3 VWD. We have observed a high prevalence of dental disease in these patients prompting us to undertake a retrospective review of our cohort of patients with type 3 VWD to catalogue the extent of their dental disease. Sixteen of these patients have been assessed by our dentistry department. Five children have undergone minor dental procedures (e.g. restorations, stainless steel crowns) and seven major procedures (e.g. dental extractions, pulpotomies and root canal treatments). These patients have collectively used 85,400 (ristocetin cofactor) IU of Humate-P on dental procedures alone. In addition to the considerable costs of factor are the cost of operating room time, dentists' costs, and the cost of other topical haemostatic agents (e.g. Tisseel) used during their dental procedures. As such there is considerable morbidity and cost from dental disease in these patients that is much higher than what is seen in patients with haemophilia or in the normal paediatric population. We speculate that the combination of these patients having a significant mucosal bleeding disorder together with various socioeconomic factors contribute to the significant degree of dental disease seen in this group of patients. We would suggest that better preventive dental care needs to be provided to these patients to avoid the considerable morbidity and very high burden of dental disease in type 3 VWD.
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Affiliation(s)
- M D Carcao
- Child Health Evaluative Sciences, Research Institute, Department of Pediatrics, The Hospital for Sick Children, Toronto, ON, Canada.
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ALPKILIÇ BASKIRT E, AK G, ZULFIKAR B. Oral and general health-related quality of life among young patients with haemophilia. Haemophilia 2009; 15:193-8. [DOI: 10.1111/j.1365-2516.2008.01919.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kabil N, ElAlfy MS, El Alfy M, Metwalli N. Evaluation of the oral health situation of a group of Egyptian haemophilic children and their re-evaluation following an oral hygiene and diet education programme. Haemophilia 2007; 13:287-92. [PMID: 17498078 DOI: 10.1111/j.1365-2516.2007.01440.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Haemophilic children in Egypt have received minimal dental intervention and their dental needs required assessment. The purpose of this study was to assess the oral health needs of a sample (n = 60) of Egyptian haemophilic children (6-12 years), so as to develop, implement and evaluate an oral hygiene education programme over an 8-month period on the experimental group (n = 30) vs. the control group (n = 30). The oral hygiene index simplified (OHI-S) index was used for baseline data and at the end of the study, while DMFS and defs were used to collect caries experience baseline data on each subject. The results showed that the DMFT and deft were significantly higher than those of the non-haemophilic population in Egypt and also higher than those of haemophilic children in developed countries and that the decayed component represented most of the index values. At phase I, the mean value of the OHI-S of experimental and the control groups was 2.67 +/- 0.45 and 2.53 +/- 0.53, respectively, but the difference was not significant (P > 0.05), both values were in the 'fair' category (1.3-3.0). At phase II, the end of the 8 months follow-up period and after the application of a strict oral care programme in the experimental group, there was a significant decrease from 2.67 to 1.20 (P < 0.001), a shift of values occurred from the 'fair' category to the 'good' category (0.1-1.2) while there was no significant difference in the control group. It can be concluded that professional plaque control, education and access to oral hygiene aids is paramount to improve oral health of these children.
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Affiliation(s)
- N Kabil
- Department of Paediatric Dentistry, University of Ain Shams, Cairo, Egypt.
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Abstract
Fifty-two young individuals suffering from severe haemophilia A and B volunteered to be compared with school- and college-going students for oral health status description and subsequent management. A total of 244 students (84.42% boys and 15.58% girls) with the age group of 13-23 years were divided into two groups, A and B (controls). The purpose of this study was to increase awareness about evidence-based dental practices by oral examinations followed by comparisons of periodontal health and prevalence of malocclusions among medically compromised students and healthy controls. Results described the oral health in severe haemophilic population to be compromised with combined simplified health index score of 0.50 and Decayed/Modified/Filled Teeth (DMFT) index score of 2.07 when compared with 0.42 and 0.95, respectively, among group B. Although prevalence of malocclusion and orthodontic treatment needs among group A were higher, yet it was not confirmed as a reason for degraded dental and periodontal status. However, spontaneous and/or toothbrush (trauma)-induced gingival bleeding episodes among group A could be explained as factors discouraging oral hygiene maintenance, particularly self-administered measures. Four haemophiliacs presented with symptoms of Temporomandibular Joint Dysfunction Syndrome (TMPDS). Evidence-based oral medicine and clinical practices need to be encouraged and applied to enhance the quality of life among haemophiliacs, particularly in developing world. Dental treatment needs of haemophilic population appear to be greater and maybe incorporated in routine dental practices, at institutional and individual levels.
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Affiliation(s)
- S Azhar
- Punjab Dental Hospital, Lahore, Pakistan.
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Correa MEP, Annicchino-Bizzacchi JM, Jorge J, Paes de Almeida O, Ozelo MC, Aranha FJP, Lourdes Barjas-Castro M. Clinical Impact of Oral Health Indexes in Dental Extraction of Hemophilic Patients. J Oral Maxillofac Surg 2006; 64:785-8. [PMID: 16631485 DOI: 10.1016/j.joms.2005.11.044] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
PURPOSE Periodontal disease in patients with hemorrhagic disorders may lead to severe bleeding during dental treatment. This study evaluated the clinical impact of oral health indexes in hemophilic patients undergoing tooth extraction. PATIENTS AND METHODS Thirty-one hemophilic patients underwent teeth extractions using autologous fibrin glue and an oral antifibrinolytic drug (epsilon-aminocaproic acid). Oral health indexes (plaque, PI; gingival, GI; and decay-missing-filling-teeth, DMFT index) were evaluated before tooth extraction. RESULTS Postsurgical bleeding episodes were observed in 6 hemophilic patients (1 severe, 3 moderate, and 2 mild type). The PI and GI index in the bleeding group were 1.8 and 1.7, respectively, and 1.8 for both of the non-bleeding groups (PI, P = .8; GI, P = .56). The global DMFT index was 18 in the bleeding group and 19.6 in the non-bleeding group (P = .67). CONCLUSION The status of oral health did not interfere with bleeding caused by dental extraction of hemophilic patients.
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Affiliation(s)
- Maria Elvira P Correa
- Dental Ambulatory, Hematology and Blood Transfusion Center/Hemocentro, State University of Campinas, São Paulo, Brazil.
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Abstract
This article aims to raise awareness among paediatricians and specialist paediatric services that poor oral health, in particular children with chronic illness, is a major cause of morbidity and can be a risk factor for severe, even life threatening complications. Good oral health and dentition is important for efficient mastication, speaking and of course, cosmetically for smiling. If left untreated, dental caries can lead to pain and infection. Chronic infection around one or more teeth can result in damage to localised structures, such as the developing permanent teeth. Children who are medically compromised (such as being immunocompromised from disease and/or therapy) however are at increased risk of developing systemic complications from dental infections, which may prove fatal. We focus on the role of the general paediatrician in promoting the importance of good dental health for all children and in particular those children "at risk". We present preventive measures, evidence based where available, that may improve dental care and promote the role of paediatric dental services in the multidisciplinary management of chronic disease.
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Affiliation(s)
- H Foster
- University of Newcastle, Newcastle-upon-Tyne, UK.
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