Oral hygiene and prevention

It’s never too late to start taking better care of your teeth and gums. Good dental care can prevent problems and the need for treatment in the future.

Managing dental disease may require the use of clotting factor concentrates, so prevention is really important. The commonest problems are gum disease (periodontal), tooth decay (cavities), and tooth sensitivity.

Healthy gums don’t bleed. If you have bleeding gums, it may not be caused by your bleeding disorder. It could be due to your oral hygiene, which can be easily managed. Good oral health means you are less likely to need invasive dental treatment.


  • Brush your teeth at least twice a day for two to three minutes; ideally, brush them after every meal. Use fluoride toothpaste to prevent tooth decay and holes in your teeth.
  • Spit, don’t rinse. Fluoride is an important ingredient in toothpaste as it helps oral health by strengthening the tooth enamel making it more resistant to tooth decay. If you need to spit and rinse, rub your teeth with a tiny amount of toothpaste afterwards to help protect them. 
  • Change your toothbrush every two to three months or sooner if the bristles are worn.
  • Use a medium bristled toothbrush and don’t brush too hard as this can cause the gums to bleed and eventually recede (especially around canine teeth and premolars).
  • Develop a good brushing technique to remove plaque (bacteria that forms on teeth) and food particles from the inner, outer and biting surface of the teeth. Brushing your tongue will also help to freshen breath and remove bacteria.
  • Electric toothbrush or manual? There is no evidence to suggest one is better than the other – if you brush and floss your teeth properly then a manual toothbrush works just as well.   Whichever you use, you must brush your teeth at least twice a day.
  • Avoid sharing toothbrushes to stop the spread of infections.


  • Ideally, you should floss every day as this keeps your gums and teeth healthy.
  • Healthy gums do not bleed during flossing, even in people with a bleeding disorder, but you may find that your gums bleed or are sore for the first few days that you floss. This should stop once the plaque is broken up and your oral hygiene has improved.
  • Try not to be too aggressive when you floss as you risk harming your gums.
  • You should contact your haemophilia centre if gums bleed for longer than 20 minutes or bleeding stops and starts again.
  • If you don’t know how to floss or you find it difficult, your dentist can give you guidance.


  • Don’t use mouthwash at the same time as brushing your teeth as it washes away the fluoride in your toothpaste. It is best to use a mouthwash at a different time.
  • Fluoride mouthwashes are good for tooth decay.
  • Chlorhexidine mouthwash (e.g. Corsodyl) help with gum problems such as bleeding gums, gingivitis, irritated gums and mouth ulcers. It also helps with healing after dental surgery or treatment. Chlorhexidine mouthwash can cause brown stains on teeth so speak to your dentist before using it. Chlorhexidine can have side effects, but not everybody gets them. If you get irritation of the mouth, soreness or swelling of the inside of the cheeks then tell your dentist or haemophilia team. 

Avoid sugary drinks and snacks

  • Avoid eating sugary foods or drinking sugary drinks and fruit juices between meals as this can cause dental cavities.  
  • Processed foods can also have high amounts of sugar in them. Check the list of ingredients before you buy them – sugars may also be listed as carbohydrates.
  • ‘No added sugar’ doesn’t necessarily mean that the product is sugar free: it’s simply that no extra sugar has been added. 
  • If you snack between meals choose healthier options such as cheese, raw vegetables, breadsticks, bananas and nuts.  
  • Drink still water, milk or diluted sugar-free fruit drinks. 

Dental hygienist

  • To prevent gum disease, visit your hygienist at least twice a year, as your teeth need to be routinely cleaned.
  • A scale and polish is usually pain free, so it’s important to let your hygienist know if you feel discomfort.
  • Removing plaque can cause bleeding gums, so it may be necessary to use a treatment such as an antibacterial mouthwash.

Back to Dental Care for Adults with a Bleeding Disorder