Inherited bleeding disorders Flashcards
Haemophilia A
inherited bleeding disorder impairing ability to make clots
factor VIII deficiency
Haemophilia B
inherited bleeding disorder impairing ability to make clots
Factor IX deficiency
Von Williebrands disease
inherited bleeding disorder impairing ability to make clots
deficiency of von williebrands factor and decreased factor VIII levels
haemophilia dentistry aspects
dental care shared between GDP and specialist haemophilia dental care centres
non bleeding procedures can be done in GP e.g check ups, restorations etc
extractions and surgeries should always be done at centres
what LA injections are safe for haemophiliacs
buccal infiltration , inter papillary , intrligamentary
AVOID - IDB, lingual infiltration , posterior superior nerve block due to bleeding risk
thrombophilia
increased risk of clots forming
thrombocytopenia
reduced number of platelets
thrombocythaemia
high numbers of poor functioning platelets
unfractioned heparin
rapid anticoagulant used in hospitals
low molecular weight heparin
short term anticoagulant , no dental issues
what does warfarin inhibit
vitamin K and therefore fit K dependent clotting factors
what drugs should not be advised for ptx on warfarin
aspirin , ibuprofen , azole antifungals
when should an INR and FBC be taken when doing treatment on a warfarin ptx
no more than 72hours before treatment ideally 24hrs
INR should be between 2-4
NOACs and dental treatments
new oral anti coagulants e.g apixiban, short duration of effect
low risk procedures no need to change dose
high risk procedures either miss morning dose or delay daily dose
avoid NSAIDS e.g aspirin and ibuprofen
anti platelet drugs and dental treatment
if solely aspirin treat as normal
if aspirin and one other treat as normal
if two antiplatelts without aspirin discuss with doctor
platelet plug wont form so excess bleeding at point of trauma
