Routine screening tests for bleeding disorders before dental care is not recommended, unless there are clinical indications.
Patients with known low platelet counts or bleeding disorders should be counseled to maintain excellent oral hygiene and regular dental check-ups.
Avoidance of dental disease can help prevent the need for more significant interventions, such as a need for factor replacement for a root canal or extraction.
Patients with a bleeding disorder should be referred to a hematologist for evaluation prior to dental interventions, but generally do not require pre-treatment for routine cleanings.
Procedures with increased risk for bleeding, such as extraction or pulp therapy, should be considered for prophylaxis.
Hematologists may prescribe tranexamic acid (an antifibrinolytic) as a mouthwash to help minimize oral bleeding with dental procedures. Prophylaxis may include coagulation factor or desmopressin or use of local hemostatic agents such as oxidized cellulose (SurgicelÂ®) or fibrin glue.