The Correlation between ORTHODONTIC TREATMENT(bracing) AND THE BLEEDING DISORDERS.

Greetings to all my dear Readers and viewers..

HOPE YOU ALL ARE DOING WELL!

Another blog to be surfaced this time is on CONNECTION BETWEEN ORTHODONTIC TREATMENT AND THE BLEEDING DISORDERS. 

Let me make you aware of the ORTHODONTIC TREATMENT:

 

TREATMENT IS MEANT FOR  ALLIGNMENT OF THE  MISALIGNED TEETH.

Orthodontic treatment is established by  the ORTHODONTIST in terms of bracing/alligners followed by retainers(TO PREVENT RELAPSE).

THIS TREATMENT IS EMPLOYED  TO FULFILL  BOTH THE AESTHETICS AND FUNCTIONAL DEFFICIENCIES. 

Let’s get to understand ..

HOW BLEEDING DISORDERS AFFECTS THE ORTHODONTIC TREATMENT:

AS YOU ALL MUST BE WELL -VERSED WITH THE BLEEDING DISORDERS:-

A Bleeding disorder is a condition involving the group of conditions dealing with the problem of the  BLOOD CLOTTING PROCESS is interrupted  by defficiency or defect /INABILITY OF THE PLATELETS TO FORM BLOOD CLOTS or defficient CLOTTING FACTORS leading to prolonged CLOTTING TIME(HEALING TIME PROLONGED).

Others can be -VASCULAR DISORDERS /FIBRINOLYTIC DISORDERS. 

 

Bleeding can happen in lieu of..

ETIOLOGY-

FIRSTLY..defective COAGULATION FACTORS/CLOTTING FACTORS.

SECONDLY..can be inherited or familial.

OTHER CAUSAYIVE FACTORS CAN BE..

Vitamim k defficiency in case of Liver disease.

Drug usage in terms of  ANTICOAGULANTS/BLOOD THINNERS. 

Long term use of ANTIBIOTICS.

 

BLEEDING DISORDERS CAN BE CATEGORIZED:-

 

A)Congenital/inherited-HEAMOPHILIA can be mild ,moderate or severe  depending upon the absence of CLOTTING FACTORS/COAGULATION FACTORS. 

Hemophilia A(COMMONEST)

Hemophilia  B

Hemophilia  C

B)Acquired(DRUG- INDUCED)

C)-Idiopathic thrombocytopenia purpura.

D)OTHER Inhereted/Congenital:-

-Von Willebrand disease (MILDER THAN HEMOPHILIA).

-THALESSEMIA-inherited blood disorder -can be MINOR /MAJOR.

 

Exhibition of BLEEDING DISORDERS IN TERMS :-

-easy bruising during instrumentation during dental procedures. 

-bleeding gums and other diet tissues.

-heavy bleeding during minor and major dental procedures.

-delayed healing.

 

DETAILED INVESTIGATION REQUIRED:-

LABORATORY investigation -

-pertaining to BLEEDING TIME,CLOTTINGTIME(BT/CT) AND OTHER BLOOD EXAMINATION( THROMBIN,PROTHROBIN TIME, ACTIVATED PARTIAL THROMBOPLASTIN TIME,PLATELET COUNT) DEPENDING UPON THE TREATMENT BASIS.

OTHER INVESTIGATIONS INCLUDING DEPENDENT MEDICAL /DENTAL HISTORYCAN BE EMPLOYED FOR FURTHER CLARITY. 

 

ORAL MANIFESTATIONS:

People with bleeding disorders either parents or children may deal with CONCERNS BEYOND TYPICAL MOUTH SORENESS OR GENERAL DISCOMFORT.

Also characterized by bleeding from multiple sites.

Oral ulceration.

Petechiae.

Hematomas.

Epistaxis. 

Congenital purpura(HEMORRHAGIC BULLAE).

Echymosis/discoloration/bruising.

Hemorrhage/Gingival bleeding -POST -EXTRACTION OR GINGIVAL CONTOURING OR CORRECTION FOR COSMETIC PURPOSE.

Hemorrhage marks in the ORAL CAVITY. 

 

CONSULTATION NOT TO BE MISSED WITH THE HAEMATOLOGIST BY THE CONCERNED TREATING DENTAL SPECIALIST. 

With the HAEMATOLOGIST ,MEDICAL SPECIALIST AND FOLLOWED BY DENTAL SPECIALIST WHO IS DEALING WITH BRACING/ALLINERS AND RETAINERS POST -TREATMENT.

 

PRECAUTIONARY MEASURES:-

Before start of treatment procedure ,patient

should consult hematologist and the treating doctor(ORTHODONTIST).

Start of antibiotics cover, mouthwash and other preventive measures to be adopted before and during the treatment specifically with bleeding disorders (factors replacement infusion should be ready) as well.

 

DIFFICULTIES FACED DURING MANAGEMENT OF THE BLEEDING DISORDER PATIENTS:-

SHEER NEGLECTED ORAL HYGIENE. 

MILD TRAUMA OR SURGERY CAN LEAD TO BLEEDING.

INHIBITORS OF THE FACTORS USED IN REPLACEMENT BEFORE AND AFTER PROCEDURES TO CURB BLEEDING.

HAZARDS OF ANAESTHESIA AND INJECTIONS.

RISK of HEPATITIS B,LIVER DISEASE,HIV(AIDS) ETC.

DRUG- INDUCED AGGRAVATION OF BLEEDING. 

ANXIETY AND DRUG-DEPENDENCE.

PATIENT NOT BEING ENOUGH CO-OPERATIVE.

 

 

OTHER OPTIONS WHICH CAN BE IMBIBED ARE:-

FOR THESE PATIENTS in terms of MINIMAL COMPLICATIONS WITHOUT BEING LIFE-THREATENING FOR THE PATIENTS. 

TRY AND INDULGE INTO CONSERVATIVE TREATMENT SO FAR IN CASE OF ORTHODONTIC TREATMENT(BRACING/CLEAR ALLIGNERS(INVASILIGN). 

-INVASILIGN CAN BE CONSIDERED IN CASE OF PATIENTS WITH BLEEDING DISORDERS. 

LASER TREATMENT FOR OTHER SPECIALTIES(ENDODONTIC ,COSMETIC PROCEDURES,PROSTHODONTIC,ORAL SURGERIES-MINOR/MAJOR),PERIODONTICS.

MICROSCOPIC DENTISTRY  INTERVENTION CAN BE ADOPTED(ENDODONTICS). 

CAD/CAM PROCEDURES FOR COSMETIC, ORTHODONTICS AND PROSTHODONTIC PROCEDURES.

MINIMALLY INVASIVE PROCEDURES ARE BEING USED IN THIS NEW-AGE DENTISTRY/MODERN DENTISTRY. 

 

KEY TO SUCCESS:- IS THE COLLABORATION BETWEEN THE PATIENT ,ORTHODONTIST AND THE HAEMATOLOGIST.

COOPERATE AS MUCH AS YOU CAN FOR A SUCCESSFUL OUTCOME. 

 

 WITH BLEEDING DISORDERS -ORAL HEALTH TAKES A BACKSEAT....

Try and understand that bleeding disorders is all -consuming compromising ORAL HEALTHCARE to be the low priority.

But CONTRARY TO ABOVE…

PATIENT SHOULD carry out PERSONALISED RECOMMENDATIONS FOR  THE ORAL- WELLBEING.

PLAQUE removal(ORAL PROPHYLAXIS).

USE of dental sealants.(PREVENTIVE).

DIETRY COUNCELLING(MINIMAL SUGAR INTAKE).

USE OF FLOURIDE(PREVENTIVE).

PROTECTIVE ELEMENTS TO BE WORN:

    Intra- Oral bleeding can be avoided              BY WEARING MOUTHGUARDS during SPORTS AND FOR THE HABITUAL BRUXORS(BRUXISM-NIGHT GRINDING).

Regular VISITS- to prevent UNDUE intra-oral bleeding happening and the restorations,appliances and prosthesis should be thoroughly examined.

USE OF INTERDENTAL CLEANING AIDS SUCH AS BRUSHES,FLOSS ETC.

TOOTHBRUSH OF MEDIUM- TEXTURED BRISTLES FOR BRUSHING.

 

RECOGNIZING A BLEEDING DISORDER IN THE DENTAL CHAIR.

Intra Oral bleeding is the commonest symptom of the bleeding disorder.

Oral health professionals easily come to know that the reason for excessive, continuous bleeding while carrying out procedures like teeth cleaning(oral prophylaxis), Oral disease, tooth eruption and exfoliation can be precursors to the  underlying bleeding disorder. 

 

CONCLUSION:-

Early DENTAL CARE TO BE UNDERTAKEN UNTILL WAITING FOR THE EXTREME OUTCOME.

THOROUGH UNDERSTANDING AND COOPERATION BETWEEN THE TREATING DOCTOR,HEAMATOLOGIST AND THE PATIENT.

A CERTAIN PROTOCOL IS FOLLOWED TO PREVENT UNNECESSARY TRAUMA NIETHER PHYSICALLY OR MENTALLY. 

 

AT THE END ,WOULD TELL YOU ALL..NO NEED TO PANIC..GO AHEAD WITH THE ORTHODONTIC APPLIANCE FOR FUNCTIONAL AND AESTHETIC STABILITY with regular preventive advice and hygiene therapy.

This will surely prevent UNDUE bleeding of the SOFT TISSUES (GUMS/GINGIVA) AND FURTHER INFECTION WITH COMPLICATIONS. 

 

So my dear readers and viewers,

I am ending my blog here..hope this Blog will make you aware of the implications of BLEEDING DISORDERS ON THE ORTHODONTIC TREATMENT AND OTHER  TREATMENTS TOO.

SEE YOU ALL SOON …

THANKYOU ..

TAKE GOOD CARE OF YOUR SMILES!!