Do hemophiliacs have a higher risk for dental caries than the general population?
OBJECTIVE
The aim of this study was to examine if patients with hemophilia were at increased risk for dental decay as compared to the general population.


METHODS
Census sampling was used in this case-control study to recruit cases (patients with hemophilia) and a control group individuals recruited randomly from the general population, which were matched with cases based on gender, age and place of residence. Clinical examinations included dental health and salivary assessments (flow rate, buffer capacity, caries-associated bacteria) and a structured questionnaire which inquired about socioeconomic status and dental health-related behaviors.


RESULTS
In the deciduous dentition, the overall caries experience (dmf) differed statistically significantly (P=0.003) between the hemophiliacs (2.6±2.6) and their matched healthy controls (6.1±2.5). Bivariate analyses did not reveal significant differences between cases and controls regarding salivary functions, except that higher bacteriological counts were found in healthy controls in deciduous dentitions than in patients with hemophilia (P=0.019). Children without hemophilia were from higher socioeconomic status families than hemophiliacs (P=0.004), but such differences were not found for adults (P=0.090). When compared to healthy adults, adult hemophiliacs had more gum bleeding at rest (P<0.001) as well as during their tooth brushing (P=0.007) and they also consumed more soft drinks than controls (P=0.025).


CONCLUSIONS
Better dental health was observed in children with hemophilia as compared to children without it. There were no differences in dental health between adult hemophiliacs and healthy controls from the general population. None of the linear multiple regression models confirmed hemophilia to be an additional caries risk when it was controlled for other caries determinants.
Institute of Dentistry, Medical Faculty, Vilnius University, Vilnius, Lithuania. Electronic address: zaliuniene@gmail.com.
Rūta
R
Žaliūnienė
Faculty of Dentistry, University of British Columbia, Vancouver, Canada.
Jolanta
J
Aleksejūnienė
Institute of Dentistry, Medical Faculty, Vilnius University, Vilnius, Lithuania.
Vilma
V
Brukienė
Institute of Dentistry, Medical Faculty, Vilnius University, Vilnius, Lithuania.
Vytautė
V
Pečiulienė
D000328:Adult; D016022:Case-Control Studies; D002648:Child; D003731:Dental Caries / Q000453:epidemiology*; D005260:Female; D006467:Hemophilia A / Q000453:epidemiology*; D006801:Humans; D008097:Lithuania / Q000453:epidemiology; D008297:Male; D009909:Oral Health; D012923:Social Class; D014094:Tooth, Deciduous; D014099:Toothbrushing / Q000706:statistics & numerical data
Dental caries; Dental indices; Dental public health; Hemophiliacs; Matched controls