Patients with low platelet counts or bleeding disorders (eg, von Willebrand’s disease or hemophilia) should be counseled to maintain excellent oral hygiene and have regular dental check-ups. Avoidance of dental disease
is crucial because it can help prevent the need for more significant interventions (ie, 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 any dental intervention, but generally do not require pre-treatment for routine cleanings. Hematologists may prescribe tranexamic acid (an antifibrinolytic) as a mouthwash to help minimize oral bleeding with dental procedures.