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Review
. 2025 Aug 21.
doi: 10.1111/hae.70104. Online ahead of print.

Dental Management for People With Congenital Haemophilia: A Systematic Review of the Existing Dental Recommendations

Mathangi Kumar  1   2 , Sulochana Badagabettu  2   3 , Keerthilatha M Pai  3   4 , Judith Angelitta Noronha  4   5 , Baby S Nayak  5   6 , Penny McCarthy  6   7
Affiliations
Review

Dental Management for People With Congenital Haemophilia: A Systematic Review of the Existing Dental Recommendations

Mathangi Kumar et al. Haemophilia. .

Abstract

Introduction: Haemophilia is the most common inherited bleeding disorder. Dental management for people with haemophilia (PwH) (both A and B) is challenging, as dental procedures may initiate bleeding episodes that may be difficult to control.

Objectives: This systematic review aimed to evaluate and summarize the existing dental guidelines that are proposed from various agencies/professional bodies, and so forth, for dental treatment procedures in PwH.

Methods: A systematic electronic search on databases like Scopus, Medline, EMBASE, CINAHL, ProQuest and Web of Science was performed. The parameters evaluated were (a) clotting factor replacement therapy employed, (b) haemostatic agents, both local and systemic therapy and (c) dental procedural and pharmacological considerations that are recommended before, during, and after dental treatment procedures for people with mild, moderate and severe haemophilia. The dental treatment procedures included all minor and major procedures, including surgical extraction of wisdom teeth.

Results: A total of 11 guidelines were included for data extraction. The results indicated that all guidelines emphasized the importance of close collaboration among haematologists and dental professionals to ensure safe and effective dental treatment as a key component of comprehensive dental care. The various dental treatments (restorative, periodontal, orthodontic and prosthodontic treatments) and preventive aspects of oral health are detailed. Also, the amount of clotting factor replacement therapy for dental procedures, and pharmacological considerations recommended from the various professional organizations are discussed.

Conclusion: Well-designed large-scale research initiatives in dental management for PwH are necessary to understand the applicability and outcomes of such guidelines in clinical practice.

Trial registration: REF/2024/01/077096.

Keywords: congenital haemophilia A; haemophilia; health systems strengthening; oral health; practice guidelines as topic.

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References

    1. World Federation of Hemophilia, World Federation of Hemophilia Report on the Annual Global Survey (World Federation of Hemophilia, 2014).
    1. A. Ruiz‐Sáez, “Comprehensive Care in Hemophilia,” Hematology (Amsterdam, the Netherlands) 17, no. S1 (2012): S141–S143, https://doi.org/10.1179/102453312X13336169156492.
    1. M. Kumar, S. Badagabettu, K. M. Pai, and B. S. Nayak, “Dental Management of People With Congenital Hemophilia: An Integrative Review of Case Reports and Case Series From a Global Scenario,” Special Care Dentistry 45 (2025): 1–10.
    1. A. Srivastava, A. K. Brewer, E. P. Mauser‐Bunschoten, et al., “Guidelines for the Management of Hemophilia,” Haemophilia 19, no. 1 (2013): e1–e47, https://doi.org/10.1111/j.1365‐2516.2012.02909.x.
    1. H. Abed and A. Ainousa, “Dental Management of Patients With Inherited Bleeding Disorders: A Multidisciplinary Approach,” General Dentistry 65, no. 6 (2017): 56–60.

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