When Clots Fail: Understanding Hemostasis, Labs, and Bleeding Risk in the Dental Chair (On-Demand)-Webinar Recording

Video Transcription

Video Summary

Dr. Bobby Tran, Chief Medical Officer at Hemophilia of Georgia, gave a practical overview of bleeding disorders for dental providers. He explained the three main parts of hemostasis: platelet plug formation, clotting factor–driven fibrin stabilization, and fibrinolysis. He emphasized that problems with platelets, von Willebrand factor, or coagulation factors can lead to different bleeding patterns, with platelet-related issues often causing immediate mucosal bleeding and factor deficiencies more often causing delayed bleeding.<br /><br />He stressed that the most important tool is a careful bleeding history, including personal and family history, medications, supplements, prior surgeries, heavy menstrual bleeding, and previous dental bleeding. Helpful labs include CBC, platelet count, hemoglobin, PT/INR, and aPTT, but normal labs do not rule out a bleeding disorder.<br /><br />The talk also covered common disorders such as hemophilia, von Willebrand disease, thrombocytopenia, platelet dysfunction, and the effects of anticoagulants and antiplatelet drugs. Tran reviewed when dental care can proceed, when to modify treatment, and when to consult hematology or cardiology. He highlighted local hemostatic measures, suturing, pressure, and antifibrinolytics like tranexamic acid as key tools for controlling oral bleeding.

Keywords

bleeding disorders

hemostasis

hemophilia

von Willebrand disease

thrombocytopenia

platelet dysfunction

anticoagulants

tranexamic acid

dental bleeding management