Conference Coverage

Consider caregiver oral health for children with bleeding disorders


Key clinical point: Improving oral health in children with bleeding disorders has significant implications for preventing bleeding episodes.

Major finding: Having a caregiver with active oral disease in the past 12 months increased the odds of the child having a suspicious lesion (OR 4.34) and gingivitis (OR 3.80).

Study details: A cross-sectional study of 226 pediatric patients who were evaluated by a dental hygienist.

Disclosures: Ms. Hastie reported having no financial disclosures.

Source: Hastie E et al. THSNA 2018, Poster 150.



– Caregiver oral health status is an identifiable risk factor that could be used to screen for poor oral health among children and young adults with bleeding disorders, results from a single-center suggest.

“We ask parents one simple question: ‘Have you had a cavity in the last year?’ If they say yes, we would be more concerned that their children would be more likely to have poor oral health,” Elizabeth Hastie said in an interview during a poster session at the biennial summit of the Thrombosis & Hemostasis Societies of North America.

Proper oral health may prevent joint disease and other conditions that predispose patients to bleeds, according to Ms. Hastie, a fourth-year medical student at Emory University, Atlanta. However, of the 147 hemophilia treatment centers in the United States, just 30% have a dentist on staff, while 90% of centers have expressed interest in increasing patient education in oral health.

In an effort to evaluate the dental habits, needs, and oral health issues of children and young adults up to age 18 with bleeding disorders, Ms. Hastie and her associates conducted a cross-sectional study of 226 patients who were evaluated by a staff dental hygienist at Children’s Healthcare of Atlanta Comprehensive Bleeding Disorders Clinic from May 2016 to October 2017.

The evaluation consisted of a 14-question survey derived from the American Academy of Pediatric Dentistry Caries–Risk Assessment Tool completed by the primary caregiver present during the visit and oral screening. The researchers extracted demographic and clinical characteristics from the patient’s chart and included age, race, county of residence, and bleeding disorder type and severity.

Elizabeth Hastie, a fourth-year medical student at Emory University, Atlanta Doug Brunk/MDedge News

Elizabeth Hastie

The majority of patients (80%) were male, 28% were African American, 51% lived within metro Atlanta, and 54% were Medicaid eligible or of low socioeconomic status. Severe hemophilia was the most common diagnosis (43%), followed by von Willebrand disease (25%), mild to moderate hemophilia (20%), and other bleeding disorders (12%).

Nearly half of the patients (44%) reported they did not brush their teeth twice a day. Children younger than age 5 years were more likely to not brush their teeth twice a day, compared with children aged 5-14 years and young adults aged 15-18 years (57% vs. 44% and 31% respectively, P = .08).

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