9/23/2015

Treating Dental Patients With Bleeding Disorders > Publications > Hemophilia of Georgia

It takes more than medicine...

Treating Dental Patients With Bleeding

Disorders
October 2007, Submitted to the Journal of the Georgia Dental Association
By Cathy Hulbert, LCSW, and Rueleen Lavergne, RN, Hemophilia of Georgia Outreach Staff
Dentists play a crucial role in the overall good health of all patients, and in particular those with
hemophilia and other bleeding disorders such as von Willebrand Disease or Platelet Function
Disorders. People who have bleeding disorders often require infusions of clotting factor or other
medications to control bleeding.
In treating patients with bleeding disorders, it is important for dentists to know that they have an
important ally in linking with hematologists at the state's hemophilia treatment centers in Atlanta at
Emory Healthcare and Children's Healthcare of Atlanta, in Augusta at the Medical College of Georgia,
and in Savannah at Backus Children's Hospital. Hemophilia of Georgia, a nonprofit organization, is a
trusted resource for medical providers and a crucial link between hematologist and dentists in the
development of patient-specific treatment plans that detail the medications required to prevent
bleeding.
During annual visits to a Hemophilia Treatment Center, people who have bleeding disorders are
encouraged to see their dentists regularly for routine cleanings and exams which usually do not
require pre-treatment with clotting factor. And they are reminded not to wait if they or their
hematologists suspect dental problems such a gum disease.
"Working hand-in-hand with HoG to get a treatment plan is the biggest step toward making this a
smooth process," said Dr. Michael Pruett, director of the General Practice Residency Program at the
Medical College of Georgia School of Dentistry. "With the proper treatment plan, these patients are
really no different from any other patients or from you and I. The biggest point that I have for dentists
is that a little knowledge about how to handle their care, and the use of Hemophilia of Georgia as a
resource, goes a long, long way to avoiding complications."
People who have bleeding disorders are taught from an early age to understand the importance of
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Treating Dental Patients With Bleeding Disorders > Publications > Hemophilia of Georgia

taking good care of their teeth and gums to prevent the need for invasive procedures which would
require pre-treatment with expensive medication as well as longer recovery periods. This message
was reinforced during Hemophilia of Georgia's Camp Wannaklot this summer. More than 150 children
and teens who have bleeding disorders learned about everyday heroes in their communities, including
dentists. Each day, a group of little "tooth fairies" made up cheers about the importance of good dental
care and performed for the rest of the campers.
In addition to educating patients and helping dentists contact the appropriate hematologists for
bleeding disorder treatment plans, Hemophilia of Georgia provides comprehensive community
services that can give doctors and nurses added peace of mind: outreach nurses and social workers
make regular follow-up calls and home visits to bleeding disorder clients and they are frequently in the
field doing in-services at emergency rooms and the offices of dentists, pediatricians and general
practitioners. In-services also are done at schools and day care centers. For physicians and other
medical providers, HoG publishes Protocols for the Treatment of Hemophilia and von Willebrand Disease
and provides a 24-hour physician-to-physician hotline for Georgia physicians who need emergency
treatment information.
HoG can also work with dentists who are treating the uninsured, often providing financial assistance
to pay for all or a portion of their bills, depending on income. In fact, HoG was founded 34 years ago so
that people in Georgia affected by bleeding disorders live as normally and productively as possible.
The HoG staff is available to answer questions and provide additional information. Please call 770518-8272 or email mail@hog.org. We look forward to hearing from you!
Additional Information About Bleeding Disorders

Hemophilia is a hereditary blood clothing disorder which affects males almost exclusively. It
results in a deficiency of clotting factor in the blood. It affects people of all races, nationalities
and economic levels.
Contrary to popular belief, people with hemophilia do not bleed to death from minor external
wounds.
The major problem for people with hemophilia and other inherited bleeding disorders is bleeding
inside the body, especially bleeding into joints such as the knees, elbows and ankles.
Current treatment for hemophilia is clotting factor, which is genetically engineered. It is infused
into the veins to stop bleeding episodes. More serious bleeding episodes require repeated
infusions.
Von Willebrand Disease (VWD) is an autosomal dominant disorder affecting males and females
equally. According to the CDC, approximately 1-2% of the U.S. population is affected by von
Willebrand Disease. Von Willebrand Factor is a clotting protein produced in cells that line blood
vessels and are slowly released into the blood stream. VWD is caused by a defect or a deficiency
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Treating Dental Patients With Bleeding Disorders > Publications > Hemophilia of Georgia

of von Willebrand Factor.

Most types of VWD can be treated with a synthetic hormone called Desmopressin Acetate
(DDAVP), either by IV or Stimate nasal spray. In some cases DDAVP does not work. In these
cases, a hematologist may recommend a clotting factor concentrate.
Patients affected by storage pool or Platelet Function Disorders have a normal amount of
platelets, but they are abnormal in size or shape, or do not function properly.

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