Outpatient treatment of hemophiliacs for dental extractions.

The outpatient treatment program for dental extraction in persons with the various forms of hemophilia has been reported. This program was initiated at the Hemophilia Rehabilitation Center at Orthopaedic Hospital in Los Angeles in 1966. During the nine years of this program, 260 patients have had 642 teeth extracted. eighty percent of these patients were outpatients and 64% of the extractions were performed on an outpatient basis. This outpatient treatment has been accompanied by an absence of a significant number of complications as evidenced by the postextraction hospitalization of only five patients during the nine-year period. The surgical technique uses a local anesthetic containing a vasoconstrictor or an ultralight intravenous general anesthetic in addition to the local anesthetic for the apprehensive or acutely infected patient. EACA is used as an antifibrinolytic agent postsurgically. Patient education and cooperation, diet control, and daily contact are important factors for the success of an outpatient oral surgery program for hemophilic patients.