A Shared Experience About Periodontitis and Bleeding Disorders

By David Huskie, Board Member, HFA

In 1985, my wife and I were dealing with the medical and insurance challenges for a two-year-old with severe hemophilia. We gave little thought to finding a dentist who would treat our son and understand the complications of a bleeding disorder. This was also during the AIDS crisis, which complicated matters even more. Dental care has much improved ever since.

Our community’s quality of life has improved; however, with longevity comes other issues of concern, such as dental health. The American Dental Association states:

Periodontitis is an advanced form of gum disease.  It is defined as a destructive bacterial infection of the gums and supporting bone. Roughly 42% of all dentate U.S. adults, 30 years of age or older, have periodontitis. To remain healthy, you must be able to maintain a healthy diet, and dental disease inhibits this, reducing the quality of life. (ADA periodontitis key points, June 9, 2022.)

My wife and I both have a family history of periodontal issues. Personally, I do not have a bleeding disorder, but have had moderate to severe general periodontitis. This was twenty years ago, and to retain my dental health, gum flap surgery was performed. The procedure was performed under local anesthesia, and the gums were surgically resected, scaling was done on the tooth surfaces, and the gums were sutured back into place. Post-procedure, there was bruising and a small amount of bleeding. I was on a liquid diet for weeks, and the discomfort lasted for many days. I could not imagine someone with a bleeding disorder dealing with such a procedure.

In April of this year, it was determined by our dentist of 30 years that something needed to be done about my wife’s general moderate periodontitis. Her dental health was not improving. My wife is considered a mild hemophiliac, and we both look dimly on gum surgery. She was offered Laser Assisted New Attachment procedure. (LANAP). Being a 45-year veteran of the bleeding disorders community, we did our due diligence research and found nothing about this procedure on individuals with a bleeding disorder. Discussing this procedure with her hematologist, she formulated recommendations for pre-procedure that were appropriate for her level of Factor VIII.

On the day of the procedure, my wife followed the recommendations of her hematologist. Upon arriving at the dental office, she was escorted into the dental room and re-examined. They placed protective glasses on, since they were using a laser, and administered local anesthesia by injection. 

The laser procedure took about 90 minutes, and aside from some aching around the gums, there were no aftereffects at the other local anesthesia injection sites. 

For two weeks, there was no brushing of teeth and a soft food diet only. Post procedure, there was no bleeding or bruising. Follow-up appointments were spaced out over the next year for evaluation of the healing progress. 

Compared to my personal experience with gum surgery, this was less traumatic, and the healing process was much shorter. 

Please note, this procedure may be costly, so check your insurance prior to committing to the procedure and
discuss this option with your dentist.