Dental habits and oral health in children and adolescents with bleeding disorders: A single-institution cross-sectional study

Introduction: Oral health is an important component of care at haemophilia treatment centres (HTCs). Correlations between oral health and inflammation suggest that proper oral health may improve joint health.

Aim: To evaluate the dental habits, needs, and oral health status of paediatric patients with bleeding disorders, and identify predicters of poor oral health.

Methods: From May 2016 to October 2017, consecutive paediatric HTC patients completed a 14-question survey and were examined by dental professionals. Descriptive analyses, chi-square tests and logistic regression models identified characteristics associated with four main dental outcomes.

Results: Evaluations from 226 consecutive patients (age 1-20 years) were included. Diagnoses included haemophilia A and B (64%), von Willebrand disease (25%) and other bleeding disorders (13%). Nearly half of patients reported not brushing their teeth twice a day (44%). One-quarter of patients did not currently have a dentist (27%), and 15% reported specific challenges with access to dental care. Oral screening demonstrated significant pathology: 89% of patients had plaque accumulation, 37% had gingivitis and 8% had lesions suggestive of dental caries. Multivariate analysis revealed that having a primary caregiver with active decay was associated with significantly higher rates of suspicious lesions (OR 4.34, CI 1.41-13.35) and gingival erythema (OR 3.44, CI 1.63-7.25) and lower rates of twice daily teeth brushing (OR .17, CI .08-.37).

Conclusion: Children with bleeding disorders commonly have significant dental pathology and report obstacles to dental care, posing the potential risk for morbidity. Primary caregiver dental health is strongly associated with dental pathology in children.