Case Series of Patients with Haemophilia Managed in a Paediatric Dental Clinic at Lagos University Teaching Hospital

Case Series of Managed Paediatric Dental Patients with Haemophilia

Abstract

Background: Bleeding disorders are a group of disorders in which
blood does not clot properly due to defects in the blood vessels,
coagulation system, or platelets. Haemophilia is one of the most
frequently occurring inherited bleeding disorders. Initial recognition of
such bleeding disorders and their possible effects plays a significant
role in reducing potential complications. This case series aims to
provide knowledge on the dental management of children with
haemophilia.
Case Presentation: We report two patients with haemophilia who
were managed in the Dental clinic by a team comprising fourth-year
residents in Paediatric Dentistry and a consultant in Paediatric
Dentistry. One of the cases was a known haemophiliac.
The first patient was a 10-year-old male who presented on account of
gingival bleeding of one week's duration. The bleeding was from a
pedunculated, well-circumscribed mass in the region of the lower left
first molar. An impression of pyogenic granuloma was made.
Excisional biopsy of the lesion was done under local anaesthesia, and
the patient was discharged home afterwards with no postoperative
complications.
The second patient was a 6-year-old male who presented to the
paediatric dental clinic on account of bleeding from the tongue
following trauma. There was a positive history of excessive post
circumcision bleeding. The patient was referred to the paediatric
haematology clinic for review after requesting for haematological
investigations. Investigations revealed a haematocrit of 21%.
Transfusion with whole blood was given, laceration was re-sutured,
and patient was placed on intravenous tranexamic acid for five days.
He was later discharged in a stable condition to be followed up in the
clinic.
Conclusion: The management of patients with bleeding disorders
depends on the severity of the condition and the invasiveness of the
planned dental procedure. The goal is to minimize the challenge to the
patient by restoring the haemostatic system to acceptable levels and
maintaining haemostasis by local and adjunctive methods.