Comprehensive Care for People With Hemophilia: A Dental Perspective From an Indian Scenario

Introduction: Hemophilia is the most common serious bleeding disorder inherited in an X-linked recessive manner. It is caused by the absence or reduced activity of factor VIII (hemophilia A) or factor IX (hemophilia B). Oral cavity is also one of the most crucial sites for bleeding in people with hemophilia. Aims: This systematic review aims to explore the oral health status of people with hemophilia and the clinical challenges encountered while treating them in a dental setting. Also to elaborate on possible recommendations and best practices to provide safe dental care for patients with hemophilia. A systematic analysis of the literature was conducted to evaluate the oral health and dentition status of individuals with hemophilia. The evidence and best practices for providing dental treatment to this population were also reviewed. Results: The results showed that individuals with hemophilia in India had a poor oral hygiene and dentition status compared to the healthy counterparts. Whereas, in the Western World, people with hemophilia had a better oral health status. This trend may be attributed to differences in treatment models for hemophilia care. Limited access to dental care and a lack of professional expertise were identified as key factors contributing to compromised oral health. Additionally, fear of hospitalization and the need for factor transfusions to manage oral bleeding were significant barriers to seeking dental care. A comprehensive care model that integrates dental care as an essential component should be advocated to prevent advanced dental disease and reduce the need for invasive procedures. Timely dental treatment can minimize the amount of clotting factor replacement therapy required. Preventive oral health measures can also eliminate the need for invasive and expensive dental treatments. Summary: Comprehensive care for individuals with hemophilia involves ongoing management of medical and psychological needs of the patient and their family. Oral hygiene and dentition status in people with hemophilia is one of the overlooked aspects in the comprehensive care. This review was conducted to understand the oral aspects in people with hemophilia from an Indian perspective and explore the role of dental care in the comprehensive care model for people with hemophilia.