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Download information for people with bleeding disorders, looking after your
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Water company contact information: Water Company Website Anglian Water Dwr Cymru Cyfngedig (Welsh Water) Northumbrian Water Severn Trent Water South West Water Southern Water Thames Water United Utilities Water Wessex Water Yorkshire Water For other water companies see http://www.anglianwater.co.uk http://www.dwrcymru.co.uk http://www.nwl.co.uk http://www.stwater.co.uk http://www.southwestwater.co.uk http://www.southernwater.co.uk http://www.thameswater.co.uk http://www.unitedutilities.com http://www.wessexwatger.co.uk http://www.yorkshirewater.com http://www.ofwat.gov.uk References: Bayer Biological Products Division (2002) A Guide for Parents of Children with Haemophilia, Newbury, Bayer Biological products. Brewer, A., Correa, M.E. (2006) Guidelines for Dental Treatment of Patients with Inherited Bleeding Disorders, Montreal, World Federation of Hemophilia. Health Options (2005) Blueprint for Health Manual, Eastbourne, Health Options Ltd. Scottish Intercollegiate Guidelines Network (2000) Preventing Dental Caries in Children at High Caries Risk, Edinburgh, Scottish Intercollegiate Guidelines Network White, J. (2002) New Horizons: A Guide to Haemophilia in the Family, Elstree, Bio Products Laboratory. Looking after your teeth and gums ... INFORMATION FOR PEOPLE WITH BLEEDING DISORDERS Although haemophilia, and other bleeding disorders, do not affect a person's teeth, it is important to maintain good dental health because the gums may bleed more easily, especially when teeth are extracted. A healthy mouth helps you to look good and feel confident, and successful prevention of dental problems will reduce the need for treatment in the future. Tips to help you look after your teeth and gums 1. Avoid sugary snacks between meals. The sugars in fruit are less likely to cause decay than refined sugars. Crisps and chocolate are better snack foods than sweets because these leave sticky residue which damages teeth and gums. Avoid fizzy, acidic drinks and drink through a straw whenever possible to protect your teeth. Dilute fruit juices with water and chew sugar free gum after eating. Ask your doctor to prescribe sugar-free versions of medicines. 2. Brush your teeth, ideally after every meal, but at least twice a day for two to three minutes. Develop a brushing routine that cleans all the top and bottom teeth on the inside, outside and biting surfaces. Haemophilia Comprehensive Care Centre Southampton General Hospital Level C Tremona Road Southampton SO16 6YD Contact us: Sister Chris Harris, Haemostasis Nurse Specialist on 02380 794047 or call the operator on 02380 777222 and ask for bleep 2947 (during office hours) In the event of an emergency call 02380 777222 and ask to speak to the Haematology Registrar “on call” 5. Fluoride supplements (including mouthwashes) can be helpful but are not recommended if the water supply has a fluoride content of 1-ppm or more). Place the bristles of the brush against the gums pointing towards the roots (A). Rotate the brush firmly so that the bristles sweep over the gums and teeth (B) 6. Visit your dentist every six months so that any problems can be identified early. Children should be taken to the dentist from the age of two. Tell your dentist about your condition and show him the Green Card supplied by your centre. Contact your haemophilia centre before any dental treatment so they can assess whether or not you need factor cover. Brush down on the upper teeth Brush up on the lower teeth Brush the biting surfaces with a scrubbing stroke Use a medium texture toothbrush with a small head to reach all parts of your mouth without damaging the gums. Replace your toothbrush regularly, at least every two to three months. Use an electric toothbrush if you prefer. Some types of electric toothbrush remove plaque more efficiently than hand brushing. Ask your dentist for advice. Brush behind the front teeth using an up-and-down stroke with the length of the brush-head (White, 2002). Use floss, tape or inter-dental brushes daily to remove particles of food and plaque between the teeth and help prevent tooth decay and gum disease. Your dentist can show you how to use them. 3. Clean baby teeth with a soft brush and water. Use a nylon toothbrush and toothpaste for children over two, and encourage them to clean their own teeth from about the age of four. 4. Use a fluoride toothpaste* 1000-ppm (parts per million) for children under 7 years old, and 1400-ppm for people over 7. Spit toothpaste out but do not rinse your mouth with water because this removes the fluoride. *Do not use fluoride toothpaste if you are taking fluoride supplements or if the water supply has a fluoride content of 1-ppm or more (see table at the end of this booklet for the major water company websites to check fluoride content in your area)
