1. Royal Disease“Hemophilia” Andal, Katrina Joie R. DMD2D
2. Definition  Hemophilia is a coagulation disorder arising from a genetic defect of the X chromosome.  Depending on the degree of the disorder in the affected individual, uncontrolled bleeding may occur spontaneously with no known initiating event, or occur after specific events such as surgery, dental procedures, immunizations, or injury.  Any of several hereditary blood- coagulation disorders in which the blood fails to clot normally because of a deficiency or abnormality of one of the clotting factors.  Hemophilia, a recessive trait associated with the X-chromosome, is manifested almost exclusively in males.
3. Signs and Symptoms External bleeding may include:  Bleeding in the mouth from a cut or bite or from cutting or losing a tooth.  Nosebleeds for no obvious reason.  Heavy bleeding from a minor cut.  Bleeding from a cut that resumes after stopping for a short time. Internal bleeding may include:  Blood in the urine (from bleeding in the kidneys or bladder).  Blood in the stool (from bleeding in the intestines or stomach).  Large bruises (from bleeding into the large muscles of the body).
4. Signs and Symptoms Bleeding in the Joints  Bleeding in the knees, elbows, or other joints is another common form of internal bleeding in people who have hemophilia.  The bleeding causes tightness in the joint with no real pain or any visible signs of bleeding. The joint then becomes swollen, hot to touch, and painful to bend. Bleeding in the Brain  Long-lasting, painful headaches or neck pain or stiffness  Repeated vomiting  Sleepiness or changes in behavior  Sudden weakness or clumsiness of the arms or legs or problems walking  Double vision  Convulsions or seizures
5. Dental Correlation  Tooth extraction in patients with hereditary hemorrhagic disorders can lead to severe bleeding , often life threatening. The association of general anti hemorrhagic treatment with local haemostatic measures for bleeding control is mandatory with these patients. The therapy protocol is the result of an interdisciplinary collaboration, between a hematologist and an oral surgeon, in order to control and to reduce the severity of postoperative bleeding.  Controlling haemorrhage by using periodontal cement packing in patients with bleeding disorders is beneficial and cost effective in dental extraction. Local techniques still requires specific replacement therapy.The adopted protocol produced a reliable outcome of dental extractions on an out -patient basis, with postsurgical comfort due to a combination of systemic treatment and local improved hemostasic measures.
6. Classifications Hemophilia A Hemophilia B Hemophilia C It is the most It is the second It is a mild form common type of most common of hemophilia. hemophilia. type of hemophilia. (Moderate) (Severe) (Mild) It is also known as It was originally Deficiency of factor named “Christmas factor XI. VIII deficiency or disease”. classic hemophilia.