| Background:Hemophilia is a group of hereditary hemorrhagic diseases that can not be radically cured by now and the major clinical manifestations are spontaneous bleeding or bleeding from injured arthroses (constitutes of70%-80%of all bleeding symptoms), muscular/soft tissues (10%-20%), oral cavity/gingivae/nasal cavities and urinary system, etc. At present, compared with the international standards, the levels of treatment and attendance to the hemophiliacs in China still have a very big disparity, for example, the levels of the oral hygiene and the treatment of the hemophiliacs. For the hemophiliacs, it is particularly important to keep the oral cavity healthy and prevent dental diseases, which not only concern their living quality, nutrition and health, but also prevent them from the risk of dental surgery.Objectives:To investigate the oral health of the hemophiliacs in Beijing and other provinces. For some severe hemophiliacs, provide them intervention of teeth cleaning under two methods of the low-dose coagulation factor replacement and bypass hemostatic drugs replacement, to examine the safety and effect of teeth cleaning and to discuss the effects of the intervention under the two methods on the safety of and bleeding condition after teeth cleaning.Methods:Randomly selected180hemophiliacs in Beijing and other provinces from Beijing Hemophilia Management Centre to investigate their healthy conditions of the oral cavity, resorting to the self designed questionnaire and oral cavity examination by specialists. For the60severe hemophiliacs who had finished the investigation of their oral health, they were divided into two intervention groups by drawing lots:the group with low-dose coagulation factor replacement and the group with bypass hemostatic drugs assistance. Pay a return visit by telephone, inquiring the patients about the daily gingivae bleeding.Results:It was found through the investigation that the hemophiliacs lacked the knowledge of preventing the dental caries and periodontal disease with20.6%-45%of the correct rate on the related questions; lacked the positive performance of visiting doctors on the oral cavity healthcare, with9.4%patients regularly resorting to teeth cleaning and10.6%patients regularly examining the oral cavity, with25%and30%respectively of taking medical treatment for gingivae bleeding and dental caries;66.7%of the hemophiliacs suffered from the spontaneous gingivae bleeding, which differed from the normal people whose gingivae bleeding resulted from the oral cavity disease, and had something to do with the hemophilia itself as hemorrhagic disease; with100%,100%and94.89%of plaque, dental calculus and bleeding detected respectively in the oral cavity examination. The teeth cleaning treatment to the patients of the two groups were safe with less bleeding amount and bleeding time than that of their daily bleeding. In addition, the daily gingivae bleeding strikingly decreased through long term observation (P＜0.001), there was no significant statistic difference between the two intervention groups on the safety of teeth cleaning and on the bleeding time after teeth cleaning (P＜0.05), the method of bypass hemostatic drugs assistance after teeth cleaning is more economic.Conclusion:The hemophiliacs lacked the professional knowledge related to dental caries and periodontal disease, lacked the positive performance of visiting doctors, mostly had the spontaneous daily gingivae bleeding and had higher rate of plaque, dental calculus and bleeding than normal people in the examination, so they were in need of education and intervention. Ultrasonic teeth scaling could be safely applied to those patients with severe hemophilia, not only clearing off the plaque, dental calculus but also improving greatly the long term daily gingivae bleeding, and the method of bypass hemostatic drugs assisting after teeth cleaning is more economic. |
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