Access to dental care for patients with inherited bleeding and hemoglobin disorders

Abstract

Aim: To identify the main barriers to dental care access for patients with inherited bleeding (IBD) and hemoglobin disorders (HbD).

Methods: Patients with IBD and HbD were invited to participate in this study between August 2019 and March 2020. Data were collected through a questionnaire consisting of socioeconomic and demographic items and questions about access to dental services and history of dental treatment. Univariate and multiple Poisson regression model was used to determine associations between professional refusal of dental care and other co-variables (p < .05).

Results: The participants (29.1%) have already had professional refusal of dental care and participants with IBD (53.2%) did not feel confident with their local dentist due to their bleeding tendency. Most (64.6%) felt apprehensive about visiting the local dentist and high prevalence of refusal to provide dental care was associated with age (prevalence ratio [PR] = 1.021; 95% confidence interval [CI] = 1.010-1.032). Individuals with low bleeding risk were less likely to be denied dental care by a professional compared to those with high bleeding risk (PR = 0.536; 95%CI = 0.291-0.990).

Conclusion: Professional refusal of dental care was high among patients with IBD, particularly older adults and with an increased risk of bleeding.

Keywords: hemophilia; hemorrhage; inherited blood coagulation disorders; oral surgical procedures; refusal to treat; sickle cell anemia; sickle cell disorders.