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MANAGEMENT OF ORAL BLEEDING: MINISTRY OF HEALTH MALAYSIA CLINICAL PRACTICE
GUIDELINES
Raja Shahardin RZ, Yahaya N

Introduction: The Clinical Practice Guidelines (CPG) in Management of Haemophilia was
published by Ministry of Health Malaysia in 2018. Objective: To provide evidence-based
recommendations on the management of haemophilia. Materials and Methods: The
Development Group members from a multidisciplinary team was formed. The dental
members of the development group consisted of a Consultant in Paediatric Dentistry and
a Specialist in Special Needs Dentistry. Under the content for dental care, three topics were
reviewed, namely preventative dental measures, dental procedures and management of
oral bleeding. The issue to be discussed is particularly on how bleeding is managed based
on Malaysian perspective. The recommendations for the management of oral bleeding are
based on the findings of systematic reviews, meta-analyses and clinical trials, with
consideration of our local practices. Results: The relative risk of bleeding in patients with
haemophilia depends on the types of dental procedures. Antifibrinolytic therapy reduces
the need for clotting factor concentrate and postoperative oral bleeding. Prior to 2018,
there was no guideline available with consideration of local Malaysian clinical practices
particularly in the management of oral bleeding in patients with haemophilia. Conclusion:
The dental care section of this CPG serves as references for dental clinicians towards
improving the quality of patient care and services.

Presented at the World Federation of Haemophilia Virtual Summit (International Conference) on 15 June 2020
th
Dr Raja Zarina Raja Shahardin
Department of Paediatric Dentistry
Tunku Azizah Hospital
Kuala Lumpur

Dr Norjehan Yahaya
Special Care Dentistry Unit
Department of Oral & Maxillofacial Surgery
Kuala Lumpur Hospital

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