Procena stanja oralnog zdravlja kod pacijenata sa urođenim koagulopatijama

Abstract

<p>Inherited bleeding disorders include diseases characterized by a tendency for spontaneous bleeding and bleeding after an injury, which are caused by a reduced amount or functional abnormalities of coagulation factors. Data on the oral health status in these patients have not yet been fully evaluated. Most dental procedures, such as tooth extractions, oral surgeries in patients with inherited bleeding disorders, require clotting factor replacement therapy before treatment. Gingivitis and periodontal diseases, and inadequate oral hygiene, may be associated with bleeding, which may necessitate treatment of coagulation factors. Advanced decay and disease of periodontal tissues may be an indication for early tooth extraction, and need to implement adequate preventative measures to improve oral health and prevent the occurrence of oral diseases in these patients. This would reduce the need for clotting factor replacement therapy, and improve the quality of life in these patients. THE AIM OF THE STUDY The aim of this study was to evaluate the distribution of oral diseases, the level of required dental treatment, dental anxiety and the impact of oral diseases on the quality of life in patients with inherited bleeding disorders, and to compare these findings with those in healthy controls. PATIENTS AND METHODS The study was a prospective epidemiological study. It included 83 patients, aged 3-25 years, who were referred to the Dental Clinic of Vojvodina. The total sample included 40 patients in the study group, those who were previously diagnosed with inherited coagulopathy, while 40 patients in the control group were completely healthy subjects. The research results were not presented for 3 patients with congenital coagulopathy, because there was no possibility to obtain all necessary information. To collect epidemiological data the following questionnaires were used: Questionnaire on the primary disease, Questionnaire on the implementation of preventive measures for oral health improvement, Questionnaire on the oral healthrelated quality of life - OHIP 14, Questionnaire with the dental anxiety scale - DAS, and a modified WHO questionnaire for oral health assessment and treatment required. RESULTS Patients with hereditary coagulopathy presented with higher prevalence of gingivitis and periodontal diseases, and poor oral hygiene in relation to the control group of patients. Temporomandibular joint was not affected by degenerative changes. The degree of dental anxiety was higher in patients with inherited coagulopathy. The oral health affects the quality of life of these patients. CONCLUSIONS The results of our study revealed that children with inherited bleeding disorders represent a special group regarding dental care. Oral health of patients with inherited coagulopathy points to the need to implement additional preventive measures, schedule more frequent check-ups, treat oral diseases in initial stages to prevent further development of diseases and occurrence of complications whose treatment requires coagulation factors.</p>