Lochana Nanayakkara
Immediate Past Chairman, Dental Committee, World Federation of Haemophilia
Safe and effective dental care for children with bleeding disorders
Each year on World Patient Safety Day, we are reminded of the need to keep safety central to all aspects of healthcare. This includes ensuring that patients with complex medical needs, especially children with developmental bleeding disorders can access safe, planned dental care.
Developmental bleeding disorders such as Haemophilia A, Haemophilia B, von Willebrand disease, and other rare clotting factor deficiencies affect how a child’s blood clots, often leading to a higher risk of prolonged or spontaneous bleeding. Even simple dental procedures can carry significant risks if not managed carefully.
Why Dental Care Needs Special Attention
For children with bleeding disorders, oral health is more than just hygiene, it’s a matter of safety. Bleeding may occur from tooth eruption, gum disease, or minor trauma from toothbrushing or eating hard foods. Invasive procedures such as extractions or scaling may lead to serious complications if performed without appropriate planning and support.
While many children with mild conditions lead active lives, those with moderate to severe disorders often require specialist input before dental treatment.
A Safe Dental Pathway: Key Principles
Advocating a model of care built on prevention, preparation, and partnership, the key recommendations include:
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Early engagement and prevention: Prioritise regular check-ups, fluoride treatments, oral hygiene advice and dietary advice to minimise the need for invasive procedures.
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Individual risk assessment: People with the same diagnosis can have different bleeding tendencies. Understand the child’s diagnosis, the severity of the child’s specific bleeding history, and current medication or prophylaxis status.
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Multidisciplinary planning: Coordinate with haematology teams, especially for extractions or surgery. Factor replacement or other therapies may be needed.
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Use of local measures: When treatment is necessary, choose minimally traumatic techniques. Use local haemostatic agents, pressure, sutures, and pressure packs where appropriate.
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Clear communication with families: Parents and carers should know what to expect, what signs to watch for, when and how to seek help and the emergency pathways available in the local area.
Creating a Safe and Supportive Experience
Children with bleeding disorders may have increased anxiety about medical or dental procedures. A safe environment includes:
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Compassionate communication and child friendly communication to build trust.
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Clear emergency protocols understood by all team members.
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Team training in managing bleeding risks and rare conditions.
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Coordinated Care with haematology teams helps to reduce unforeseen bleeding complications
Patient Safety Starts with Awareness
Dental professionals are in a unique position to protect the health and wellbeing of children with inherited bleeding disorders. As part of our commitment to World Patient Safety Day, the Faculty of Dental Surgery encourages all practitioners to:
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Reflect on how their practice accommodates vulnerable patients
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Seek opportunities for continuing education
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Promote collaboration between general and specialist services
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Foster relationships with the patient’s medical care team early
Working Together for Safer Care
For children with bleeding disorders, safe dental care is planned care. It requires early prevention, timely risk assessment, and clear pathways for support. With the right preparation, children with these conditions can enjoy excellent oral health safely.