Endodontic management of dental pain in an inhibitor positive, severe Hemophilia A patient: A brief review and report of a case

Abstract

Dental health care providers often have to deal with patients requiring special care during treatment planning, and certain precautions while carrying out the procedures, and patients with bleeding disorders are one of them. Hemophilia, an X-linked blood dyscrasia, is the most common bleeding disorder. While hemophilia-A is a deficiency of factor VIII, hemophilia-B (Christmas disease) is a deficiency of factor IX. The present paper presents a case discussing endodontic management of mandibular molars with irreversible pulpits in an inhibitor positive severe hemophilia-A patient. As such patients may require administration of inferior alveolar nerve blocks, so adequate factor levels should be ensured before initiation of local anesthetics. Furthermore, the authors have tried to highlight the barriers to oral health care suffered by such patients and the larger role played by the physicians and oral health care providers in the prevention, early detection, and timely intervention in these cases.