title: Effectiveness in controlling haemorrhage after dental scaling in people with haemophilia by using tranexamic acid mouthwash.
abstract: OBJECTIVE
  To compare the effectiveness of tranexamic acid mouthwash (TAMW) in controlling gingival haemorrhage after dental scaling with that of using factor replacement therapy (FRT) prior to dental scaling in people with haemophilia.
  
  
  METHODS
  Double-blind cross-over randomised control trial.
  
  
  METHODS
  Dedicated hospital dental practice for patients with inherited bleeding disorders.
  
  
  METHODS
  Sixteen patients with haemophilia who required dental scaling participated in this pilot study. The experimental treatment regime (ETR) involved transfusing each patient with saline before scaling both quadrants on one side of the mouth followed by oral rinsing with TAMW four times daily for up to eight days. The control regime (CR) involved giving each patient FRT before scaling the opposite side of the mouth followed by use of a placebo TAMW. Each patient underwent both treatments in a random-ised sequence. Both the operator and the patients were unaware of which were the ETR and CR episodes. On both occasions the patient kept a log book of the rinsing regime and any post-operative bleeding. Additionally, a structured post-treatment telephone interview was conducted to assess the effectiveness and the patient acceptability of the ETR.
  
  
  RESULTS
  Thirteen patients completed the study. No statistically significant difference was found in gingival bleeding and mouthwashing frequencies between the ETR and the CR (p > 0.05). Five patients reported no gingival bleeding with either the ETR or the CR. No patient, using either regime, required extra FRT due to gingival haemorrhage. All subjects found the ETR acceptable and easy and reported feeling safe in using TAMW alone to control gingival bleeding after dental scaling.
  
  
  CONCLUSIONS
  TAMW use after dental scaling was as effective as using FRT beforehand in controlling gingival haemorrhage for people with haemophilia.
authors.affiliation: Community Dental Service for Camden and Islington Primary Care NHS Trusts, London.
authors.forename: A P H
authors.initials: AP
authors.lastname: Lee
authors.forename: C A
authors.initials: CA
authors.lastname: Boyle
authors.forename: G F
authors.initials: GF
authors.lastname: Savidge
authors.forename: J
authors.initials: J
authors.lastname: Fiske
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D018592:Cross-Over Studies; D017742:Dental Care for Chronically Ill; D012534:Dental Scaling; D004311:Double-Blind Method; D005164:Factor IX / Q000008:administration & dosage; D005169:Factor VIII / Q000008:administration & dosage; D006467:Hemophilia A; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D009067:Mouthwashes / Q000627:therapeutic use*; D006472:Oral Hemorrhage / Q000517:prevention & control*; D010865:Pilot Projects; D011182:Postoperative Care; D019106:Postoperative Hemorrhage / Q000517:prevention & control*; D011300:Preoperative Care; D018709:Statistics, Nonparametric; D014148:Tranexamic Acid / Q000627:therapeutic use*
chemical_list: D009067:Mouthwashes; D014148:Tranexamic Acid; D005169:Factor VIII; D005164:Factor IX