Study Finds No Differences in Oral Health Quality of Life in Children With Hemophilia

Joana Carvalho, PhD avatar

by Joana Carvalho, PhD |

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Despite having lower oral health scores, children with hemophilia showed no differences in oral health-related quality of life compared to children without the condition, a study found.

The study, “Parent’s report on oral health‐related quality of life of children with haemophilia,” was published in Haemophilia.

Hemophilia is a genetic blood disorder that affects the body’s ability to make blood clot to prevent excessive bleeding. Disease severity varies depending on the degree of deficiency in blood-clotting factors.

Although spontaneous bleeding episodes negatively affect quality of life, patients can lead a normal life with proper treatment and self-care. This also applies to oral health, an area encompassing all types of dental procedures, which, if not correctly managed, might have a negative impact on daily activities, including eating, smiling, speaking, learning, and socializing.

“Poor oral health is considered the major risk factor of bleeding from oral region in children with coagulation disorders [along with] dental treatments which [may employ] bleeding-associated
procedures,” the researchers stated.

In this study, a team of researchers from the Çukurova University in Turkey analyzed and compared the oral health-related quality of life of children with and without hemophilia from their parents’ point of view.

“The subjective evaluation of oral health-related quality of life (OHRQoL) reflects children’s comfort while eating, sleeping and engaging in social interaction, their self-esteem and their satisfaction of existing oral health situation,” the scientists said.

The cross-sectional study enrolled 300 children — 76 with hemophilia (49 with hemophilia A, 14 with hemophilia B and 13 with von Willebrand disease) and 224 healthy controls — ages 2-14.

The pediatric oral health-related quality of life (POQL) questionnaire was used to measure children’s quality of life. All assessments, including the POQL, demographic information, general health and oral health-specific questions, were provided by the children’s caregivers.

All study participants performed a dental screening in which they were evaluated by dmft (number of decayed, missing and filled teeth from the primary dentition) or DMFT (same as dmft, but for permanent dentition) scores defined by World Health Organization (WHO) guidelines, treatment urgency, and overall dental hygiene.

According to carers, 31.7% of children in the control group brushed their teeth more than once a day and 44.6% visited the dentist in the past six months, while only 5.3% and 25% of the children in the hemophilia group did the same, respectively.

In the hemophilia group, 25% of parents considered the oral health of their children poor, compared to 12.9% in the control group.

Moreover, results showed that dmft scores were significantly higher in children with hemophilia compared to healthy controls (3.5 vs 2.6), indicating that children with hemophilia had worse primary dental health. However, despite these lower oral health measures, there were no significant differences in treatment urgency, overall dental hygiene, and OHRQoL between the two groups.

“This paper has shown that oral health parameters and OHRQoL in younger children need to be improved while physiological barriers against tooth brushing should be taken into account. The importance of conservative management of primary dentition should be added to the agenda of professionals dealing with children with hemophilia,” they concluded.