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Sammanfattning

Management of patients with congenital coagulation defects in general dental practice and hospitals: Haemophilia and von Willebrand disease are inherited coagulation defects, von Willebrand disease being the most common. There are two main types of haemophilia, haemophilia A and B of which Haemophilia A is the most common. The absence or very low levels of clotting factors in the blood compromises hemostasis. Therefore, there is an increased risk of bleeding related to oral surgery in these patients. The purpose of the present article is to provide an overview of the various coagulation defects and outline how the treatment in this patient group is organized from the general dental practitioner to the hospital system. Additionally, the use of local and systemic haemostatic agents are described. Handling of patients with inherited coagulation defects depends on the severity of the defect and extent of the treatment. A carefully coordinated medical plan prior to surgical treatment is required and includes pre-, intra-, and post-operative approaches to optimization of haemostasis during and after the procedure. In need of oral surgery, this type of patients requires referral from their own dentist to the department of oral and maxillofacial surgery with highly specialized functions in Aarhus University Hospital or Rigshospitalet for treatment under the instructions of the plan for bleeding prophylaxis of haemophilia centre. Thereby, patients can be treated with the least possible risk of bleeding complications and the possibility of monitoring after treatment. Regular dental procedures including restorative procedures, scaling, and endodontics can usually be undertaken/performed in general dental practice.

MeSH