Disorders of Blood

7/27/2019 Disorders of Blood

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DISORDERS OF

BLOOD



Coagulation Disorders :

Hemophilia

Hemophilia AHemophilia B

Hemophilia C

diseasewillebrand’sVon

DISORDERS OF BLOOD…



Pulp treatment of primary teeth, if

indicated is to be done to avoid

extractions.

Primary teeth when shed in normal way

cause little or no hemorrhage. However,

if very mobile, extraction may be

necessary.

DISORDERS OF BLOOD… HAEMOPHILIA..

Dental Care



Never give Inferior dental nerve blocks as

bleeding in Pterygomandibular region may

result in Asphyxia.

Haemostatic agents to be administered

during periodontal procedures.

DISORDERS OF BLOOD… HAEMOPHILIA

Dental Care..



Extraction -adequate replacement therapy

and careful monitoring of factor VIII and

factor IX levels.

Acrylic Splint – To maintain Clot in place.


Dental Care..



Surgical procedures :Factor VIII : at least 30%

Factor IX : at least 30-50%

• Factor VIII : Parenteral 1-deamino 8-D

arginine vasopressin

• Factor IX : Purified prothrombin complex

concentrates.


Dental Care..



Routine therapy with Anti-fibrinolyticagents:

Tranexamic acid

Epsilon Aminocaproic acid

Prior to and for a few days following

the procedure.


Dental Care…



Dental Care..


Medications containing aspirin

(salicylates) must not be prescribed.

Paracetamol compounds – safe.

Non-steroidal anti-inflammatory drugs

are contraindicated.

Avoid Saliva Ejectors.



Preventive treatment is important.

Topical / Systemic fluorides at regular intervals.


Dental Care..



Bite wing radiographs should be taken at

regular intervals .

Careful application of matrix bands and

retainer.

DISORDERS OF BLOOD… HAEMOPHILIA..

Dental Care..



THROMBOCYTOPENIA

Reduction in number of platelets

(Normal range : 1.5 - 4.0 lac/mm3)




Characterized by :

Petectial Hemorrhages

Haematemesis

Hematuria

Malena Sub mucosal hemorrhage in

palate

DISORDERS OF BLOOD… THROMBOCYTOPENIA



THROMBOCYTOPENIADISORDERS OF BLOOD…

Dental Care

Platelet count should be estimated.

Scaling & Root planing – 60,000/mm3

Surgical Procedures – 80,000/mm3

Corticosteroids (Prednisolone) – Increase

platelet count.



• Infiltration anesthesia, Scaling,

Root planing : INR < 3.0

• Block anesthesia, Minor

surgery, Extractions : INR < 2.0

• Major surgery : INR < 1.5


Dental Care…



Surgical treatment should be as

Atraumatic as possible.

Local Hemostatic measures should be

applied.

Platelet transfusion may be required

before surgery.


Dental Care…

SO S O OO



SICKLE CELL ANAEMIA

Clumped together, blocking small blood

vessels, reduction in blood supply and

thereby necrosis of tissue supplied.


DISORDERS OF BLOOD SICKLE CELL ANAEMIA



Dental Care

Level of Haemoglobin should be

investigated before extraction orsurgery.

Level of Haemoglobin – S should

be less than 30%.

DISORDERS OF BLOOD… SICKLE CELL ANAEMIA

SICKLE CELL ANAEMIADISORDERS OF BLOOD



Poor healing may ensure after

surgical dental procedures.

L.A should be used in preference

to G.A .

Prophylactic Antibiotics.

SICKLE CELL ANAEMIADISORDERS OF BLOOD…

Dental Care…

DISORDERS OF BLOOD



THALASSAEMIA

Disorder of Haemoglobin synthesis.

Expansion of medullary cavities of facial

bones, which gives rise to expansion of

maxilla, creating protrusion of middlethird of face.


DISORDERS OF BLOOD THALASSAEMIA



Dental Care

Gradual expansion of maxilla obviously

has repercussions as far as orthodontic

management is concerned.

HIV screening is must.

DISORDERS OF BLOOD.. THALASSAEMIA

DISORDERS OF BLOOD



LEUKEMIA

Malignant disease in which thereis widespread proliferation of WBC’s.

Spontaneous haemorrhage from

gingiva.


DISORDERS OF BLOOD LEUKEMIA



Dental Care

No treatment should be carried out until

the patient is in remission unless there isan emergency.

DISORDERS OF BLOOD… LEUKEMIA




Swabbing the mouth with an

antibacterial solution may help to

prevent ulcers.

Mouth washes with local anaesthetic

properties may be beneficial.


Dental Care…




Inferior dental blocks are contra indicated as

there is possibility of deep hemorrhage.

Bleeding time and platelet count should be

checked before extractions or extensive

scaling.

Dental Care..





Susceptible to infections - maintained onprophylactic antibiotics.

If viral infections such as Herpetic gingival –

stomatitis develop, then IV or Oral Acyclovir.

If Candidial infections occur, Treat with

Amphotericin B, Nystatin or Fluconazole.

Dental Care..




Mousavi , nayyereh

DMD4D

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Disorders of Blood