The Connection Between Oral Health And Bleeding Disorders

Dr. Christopher Li Etobicoke - Li Family Dental

By Dr. Christopher Li

October 21, 2023

dental care, dental health, oral care, oral health, oral health and bleeding disorders, preventative care

Bleeding disorders cause excessive bleeding. Although there are several types of bleeding disorders, the most common in Canada are Hemophilia A, which impacts about 2,500 Canadians, and Hemophilia B, which affects about 600. In most cases, bleeding disorders are caused by an inherited gene mutation impacting clotting factors. Here we explain the connection between oral health and bleeding disorders and why dental care is so important.   

What Causes Bleeding Disorders And Why Are They Dangerous?

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Bleeding disorders are usually passed on via a gene mutation that impacts blood clotting. As an inherited condition, the genes related to blood proteins or platelets are faulty, leading to the risk of prolonged bleeding. Other possible causes of bleeding disorders include medical procedures, conditions, and medications.

Blood disorders are dangerous because while minor cuts can cause issues, should someone experience injuries leading to internal bleeding, their risk for death is relatively high. For women, bleeding in childbirth or even during menstruation can present risks. Surgical procedures, including dental treatments, can also be risky, especially in patients where the bleeding disorder has not been diagnosed. 

How Are Bleeding Disorders Treated?

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Common treatments for bleeding disorders include factor replacement therapy, iron supplements, topical products or sprays to help healing, and, in worse-case scenarios, blood transfusions. 

What Are The Symptoms Of Bleeding Disorders?

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Symptoms of bleeding disorders might include the following:

  • Skin discolouration and frequent bruising
  • Swollen joints related to internal joint bleeding
  • Bleeding gums while brushing or when having dental work performed
  • Heavy bleeding from minor cuts
  • Frequent nosebleeds
  • Excessively heavy periods for women 

What Precautions Are Required For Those Living With Bleeding Disorders? 

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You might be surprised to learn that people with bleeding disorders should improve their dental health, as both bleeding gums and tooth loss or extractions can present risks. Therefore, reducing sugar intake and eating a healthy diet is essential. A proper diet increases blood cell production and volume while reducing oral bacteria and plaque buildup. Be sure to read food labels and avoid foods that contain high levels of sugar and fats, while choosing foods with high daily levels of vitamins and minerals. Also, speak to your pharmacist or doctor to discuss any supplements and medications you are taking, as many can increase the risk of bleeding, including:

  • Multivitamins
  • Combinations that include fish oil and ginkgo Biloba
  • The mixing of iron and green tea
  • Bromelain
  • Flaxseed
  • Garlic
  • Ginger
  • Aspirin
  • Ibuprofen
  • Blood thinners

Finally, try to avoid or reduce alcohol use. 

What Is The Importance Of Dental Care For People With Bleeding Disorders?

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As mentioned, gum disease, tooth loss, and some dental treatments can be risky for patients with bleeding disorders. Therefore preventative care is essential, including regular dental checkups and a thorough home oral hygiene regime. This is the best way to help prevent the build-up of plaque and tartar that cause gum diseases and tooth decay. To ensure you are practicing proper oral care, follow these tips:

  • Be sure to speak to your dentist about your bleeding disorder
  • Brush twice a day
  • Use a medium to soft bristle toothbrush
  • Choose fluoride toothpaste
  • Ask your dentist about the safest and most effective interdental cleaning tools, i.e., dental floss
  • Ask your dentist to recommend a mouth rinse with antibacterial and astringent ingredients
  • Schedule dental checkups and cleanings every six months 

Is There A Connection Between Oral Health And Bleeding Disorders?

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Yes. First, it is often your dentist who first suspects a patient might have a bleeding disorder. If they observe unusual bleeding during your initial exam or at cleanings and checkups, they will consider the possibility of a bleeding disorder and ensure you speak to your family doctor. Second, if you have a bleeding disorder, you have a higher risk for decay and gum disease. This is not caused by your condition but instead because it is common for patients with bleeding disorders to associate dentists with bleeding risks. As a result, they avoid dental visits.

However, dental care is vital to prevent bleeding related to gum and dental issues. Your dentist ensures you receive preventative maintenance to reduce your risk for conditions that can aggravate bleeding, such as periodontal disease and tooth decay. They ensure you maintain proper home oral hygiene and provide professional cleanings to remove plaque that contributes to oral health issues. By avoiding the dentist, you increase the risk of oral bleeding. Just remember that dental bleeding is minor, presenting minimal risks, especially when you maintain proper oral hygiene habits.   

What Precautions Are Required For Dental Care And Bleeding Disorders?

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Proper management of bleeding disorders is a fundamental practice by dental professionals. We understand that the condition can present risks and take every precaution to ensure safety. It begins with discussing your condition and history to track past bleeding events related to dental treatments. We can determine the risks presented by your history and the seriousness of your condition. When providing a treatment plan, we look at the invasiveness of each treatment so we understand the risks presented. From there, we can make special accommodations to minimize risks, including:

  • Pain management during procedures to keep you comfortable, such as sedation
  • Patient critical precautions such as consultation with your treating doctor, avoiding unsuitable pain medication, and prescribing customized post-operative care
  • Ensuring your preventative care prioritizes periodontal health care and reduction of plaque, as well as reduced risk of extraction or tooth loss
  • Addressing fears of dental-related bleeding through education
  • Using ultrasonic instruments to reduce bleeding
  • Education about proper home care to improve oral hygiene habits
  • Application of rubber dams, use of clamps, wedges, etc., to reduce and manage bleeding
  • Avoiding extractions with treatments such as root canals
  • Prescribing medications safe for bleeding disorders

We are here to help alleviate your fears related to bleeding during dental appointments. We will help you understand why risks are minimal and how effective oral care is the key to reducing bleeding associated with your gums and teeth.

For more information about dental care for bleeding disorders, call our team at 416-232-2033 or request an appointment to discuss your condition by clicking here.

Dr. Christopher Li

About the author

Doctor Christopher Li, DDS
Dr. Chris, as he is affectionately known, is a licensed dentist with over 20 years experience. His caring personality makes even the most tentative person at ease. Patients are constantly commenting about how Dr. Chris is incredible at delivering pain-free freezing, and how he has an amazing chair-side manner.  Dr. Chris loves sharing information with his patients and everyone who has teeth about how to care for their teeth, avoid tooth decay, and the treatments available to help them overcome their tooth pain or other dental issues so they can enjoy life and food to its fullest!

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