Across Scotland no-one with a bleeding disorders should be paying for dental interventions (such as extractions) which are specialist services. However, it seems as though there have been different arrangements when it comes to routine dental work.
Good oral health is extremely important for anyone with a bleeding disorder. Haemophilia Scotland’s position is that charging is a false economy as any deterioration in the oral health of people with bleeding disorders runs the risk of increasing the demand for clotting factor products in the future. Any saving could be quickly wiped out if more people need cover for tooth extractions or other dental interventions. We also believe that financial considerations should not be placed ahead of providing the best possible treatment and care.
The United Kingdom Haemophilia Doctors’ Organisation (UKHCDO) guidelines on dentistry make set out the content for these charges very well saying,
A major anxiety of patients with congenital bleeding disorders is the risk of bleeding either during or after treatment, as well as concerns about dentists’ understanding of their bleeding condition and its management.Many patients also worry when their gingivae bleed on brushing and so avoid brushing, which exacerbates the problem, especially if preventive dentistry is difficult to access in a primary care setting. A significant number of patients have also experienced the refusal of treatment by general dental practices. As a result, individuals may avoid the dentist until extensive treatment needs arise. This group of patients requires the same level of routine dental care as any other patient and good preventive practice is essential. A retrospective audit of the dental health status of 31 consecutively referred haematology patients attending a Scottish dental hospital demonstrated that untreated decay and numbers of missing teeth increase significantly with age, and delays in intervention result in extractions becoming the chosen treatment.With a few exceptions (for example, exfoliation of deciduous teeth, orthodontic extractions, removal of impacted wisdom teeth) a dental extraction should be viewed as a treatment failure.
We have taken this issue up with National Services Division (NSD) and know they are talking to the Chief Dental Officer on our behalf. In the meantime we are suggesting that everyone affected continues attending their routine dental appointments but keeps any receipts for new dental charges.
We would also like to know how many people are affected. If this issue affects you and you’d like us to keep you up to date then please fill in the short dentistry survey below.