title: Special Care Dentistry: Part 2. dental management of patients with drug-related acquired bleeding disorders.
abstract: The first of this series of three articles discussed the dental management of patients with inherited bleeding disorders. This paper will discuss and outline the dental management of patients with acquired bleeding disorders that can result from drug therapy. These may be associated with vascular defects, platelet defects or coagulation defects. In an age when people are living longer, and medical interventions are continually becoming more advanced, clinicians will need to be aware of systemic disorders and treatments that may cause complications in the dental setting. According to National Statistics, the UK population is projected to increase by 0.7% by 2016. This trend is shared with other European countries which also have ageing populations. The proportion of people aged over 65 is predicted to increase from 16% in 2006 to 22% in 2031.
  
  
  CONCLUSIONS
  Being able to recognize which drugs may cause bleeding problems at an early stage will lead to good patient management, particularly in planning and delivering treatment following invasive procedures such as dental extractions. Whilst most patients can be successfully treated in general dental practice, the clinician may need to make a decision on whether or not to refer a patient to specialist services for all dental treatment, or to share care between primary care and specialist services for selected procedures.
authors.affiliation: Department of Sedation and Special Care Dentistry, Guy's Hospital, London Bridge.
authors.forename: Najla
authors.initials: N
authors.lastname: Nizarali
authors.affiliation: Department of Community Special Care Dentistry, King's College Hospital NHS Foundation Trust, London, UK.
authors.forename: Sobia
authors.initials: S
authors.lastname: Rafique
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D000925:Anticoagulants / Q000627:therapeutic use; D000970:Antineoplastic Agents / Q000627:therapeutic use; D001778:Blood Coagulation Disorders / Q000503:physiopathology; D000077144:Clopidogrel; D017742:Dental Care for Chronically Ill; D004358:Drug Therapy; D006474:Hemorrhagic Disorders / Q000503:physiopathology; D006487:Hemostasis / Q000502:physiology; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008517:Phytotherapy; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use; D011517:Prothrombin Time; D013988:Ticlopidine / Q000031:analogs & derivatives / Q000627:therapeutic use; D014859:Warfarin / Q000627:therapeutic use
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000925:Anticoagulants; D000970:Antineoplastic Agents; D010975:Platelet Aggregation Inhibitors; D014859:Warfarin; D006493:Heparin; D000077144:Clopidogrel; D013988:Ticlopidine