Non-Malignant Blood Disorders and Their Impact on Oral Health: an Overview

This review aims to summarize the literature on inherited hemoglobin and coagulation disorders, focusing on sickle cell disease (SCD), thalassemia, hemophilia, and von Willebrand disease (vWD), and their impact on oral health. Clinical dental management of patients with these conditions is also reviewed. There is no evident association between caries and SCD. Despite limited available studies, there may be a possible association between caries and thalassemia, which could relate to salivary changes in immunoglobulin A and Streptococcus mutans reported in these patients. Controversial results on the caries experience of hemophilia and vWD patients are found in the literature, which are likely to reflect differences in the provided preventive dental care of these patients rather than a biological association. Current evidence does not support any association between periodontal disease and SCD. The literature on periodontal disease and thalassemia shows controversial results although some evidence suggests differences in the gingival inflammation of thalassemia patients with increased levels of inflammatory cytokines and matrix metalloproteinases, deserving further investigation. The available literature does not provide evidence of an increased risk for gingival bleeding or periodontal disease in patients with hemophilia or vWD. Dental management of these patients requires appropriate measures to prevent infection and excessive bleeding. The use of local hemostatic may often be sufficient; however, in severe bleeding disorders, systemic hemostatic or replacement therapy may be required, and procedures are recommended to be planned with the patient’s hematologist. Maintaining good oral health through preventive dentistry is important for patients with inherited hemoglobin and coagulation disorders as that may prevent the risk of infection and the need for invasive dental treatments that can result in bleeding complications.