Dental care for children and young people with inherited bleeding disorders
It is very important for children and young people with bleeding disorders to care for their teeth and gums. Regular visits to the dentist will reduce the risk of dental decay and mouth infections. Find out more information on dental care with inherited bleeding disorders.
Essential tips for maintaining healthy teeth
- Start toothbrushing as soon as the first baby tooth appears
- Bring your child to the dentist by their 1st birthday
- Brush your child’s teeth before bedtime and one other time during the day
- Children with special healthcare needs should use a smear (rice sized amount) of 1450ppm fluoride toothpaste as soon as the first tooth appears. From 2 years of age for all children, use a pea-sized amount
- All children should be supervised with toothbrushing until at least 7 years of age
- Encourage your child to spit and not rinse their mouth after brushing. This gives the fluoride its best opportunity to work
- Avoid frequent snacking in between mealtimes. Remember: Water is the safest drink for teeth!
- Attend the dentist regularly
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Toothbrushing
Teething
Your baby’s lower front teeth will usually come through first, at about age 6 months. The upper front teeth usually follow. For most babies, teething is a straightforward process, but some children may feel pain and need extra comfort at this time.
Children with haemophilia sometimes encounter bleeding when their baby teeth appear. Prolonged bleeding during teething can be one of the first signs of haemophilia. However, most children with bleeding disorders do not have problems with bleeding when teeth come in and fall out.
When should you brush their teeth?
As soon as the first tooth appears! Remember baby teeth are just as important as adult teeth. Use a small soft-headed child sized toothbrush to brush their teeth. There is some evidence to show that powered toothbrushes can remove more plaque than manual toothbrushes.
However, a manual toothbrush used properly can be as effective. Brushing at night is very important and at least one other time during the day.
You should continue to supervise toothbrushing until your child is at least 7 years of age.
What toothpaste should you use?
In general, children under 2 years of age do not need toothpaste. However, we recommend that children with bleeding disorders use a fluoride toothpaste (like the rest of their family). Children with special healthcare needs should use a smear (rice sized amount) of 1450ppm fluoride toothpaste. From 2 years of age, they should use a pea-sized amount of toothpaste.
Do not rinse your child’s mouth after toothbrushing. Remember the mantra – ‘Spit, Don’t Rinse!’. If your child rinses their mouth with water after toothbrushing, the toothpaste will wash away and you will lose the benefits of the fluoride protection.
Healthy gums
Don’t be afraid to brush!
Healthy gums do not bleed. If your child’s gums are bleeding, this could be a sign of gum disease, which can be caused by poor toothbrushing. Continue to brush even if there is bleeding as this will help to reduce the level of bacteria in your child’s mouth.
If you are a healthcare professional concerned about a child with bleeding gums, please refer them to a dentist for investigation in the first instance.
Dentist visits
When to visit the dentist for the first time?
As soon as the first teeth appear, consider bringing your child to the dentist. If possible, try to bring them before their first birthday. This is to familiarise your child with the dental environment and reduce the risk of future dental anxiety. Try not to worry if they don’t want to open their mouth, their first visit to the dentist is an opportunity for your dental team to give you advice on how to care for your child’s mouth.
Every child with a bleeding disorder should attend the dentist 3-4 times per year.
What types of treatment can the dentist do?
You should always inform your dentist about your child’s bleeding disorder. Tell your dentist the names of your child’s haematology team in case your dentist needs advice. Most children and young people can attend their local dentist for check-ups and treatment. However, a small number with severe bleeding disorders may have their dental care in a specialist hospital setting.
Your child’s haematology team will let you know which dentist to bring your child to.
Dental injuries
If your child has a dental injury, management of this can be more complicated if they have a bleeding disorder. In the case of dental trauma, you should contact your dentist and your child’s haematology team.
If your child plays contact or ball sports, they should wear a sports mouth guard to protect the teeth. Mouth guards will need to be changed regularly, to ensure of a good fit and hygiene especially if they have both baby and adult teeth.
Diet
A healthy diet is just as important as effective toothbrushing. Try to avoid snacking in between mealtimes. Frequent sugar snacks and drinks can increase the risk of tooth decay. Avoid sticky foods e.g. raisins which can cling tightly to teeth and are hard to remove.
Avoid fizzy drinks, juice and other fruit drinks. Water is the safest drink for teeth!
As your child or young person gets older, it will be harder to control what they eat and drink. Try to encourage them to limit snacking in between mealtimes.
Be aware that processed foods can contain high amounts of sugar. Check the list of ingredients before you buy them. Remember, certain foods marketed as being ‘healthy’ do contain a lot of sugar e.g. sports drinks. ‘No added sugar’ does not necessarily mean sugar free. It simply means that no extra sugar has been added to the product.
For more on diet and nutrition, please see our nutrition and dietetics information.
Braces
Having a bleeding disorder does not mean that your child cannot have orthodontic treatment. If your child needs braces, your orthodontist should discuss their plan with your child’s haematology team before treatment begins. Your child or young person's haematology team will need to agree that treatment is possible and will advise your orthodontist on the specific precautions they need to take.
When fitting braces, your orthodontist will take special care to avoid damage to gums. They may give your child or young person some wax strips to help protect the gums from sharp edges.
Food and plaque can get stuck in between the wires and brackets which can lead to gum inflammation. Remember, good toothbrushing is essential when wearing braces.
For more information on orthodontics and to find an orthodontist near you, please visit https://www.orthodontist.ie/