A Cohort Study and Matched Pair Analysis Evaluating the Effects of the COVID-19 Pandemic on Access to Dental Care for People With Inherited Bleeding Disorders

Objectives: Patients with inherited bleeding disorders (IBDs) can experience challenges in accessing dental care. The COVID-19 pandemic saw the cessation of routine dentistry in England. This study aims to highlight whether access to dental care for patients with IBDs was impacted by the pandemic, and whether the severity of their IBD impacts patients experience of dental care.
Methods: Patients over the age of 18 with Haemophillia A and B, Von Willibrands (VWD), Bernard-Soulier syndrome (BSS) and Glanzmann’s disease (GD) were recruited. 178 patients were called and invited to complete a questionnaire. Full cohort and matched pair analysis was performed.
Results: 70 participants completed the questionnaire (62 males, mean age 39.9), 26 had a mild IBD and 44 severe. Mild and severe patients were matched on IBD, gender, deprivation index and age. 31% of patients tried to seek dental advice during the pandemic. 81% of mild patients saw a dentist routinely prior to the pandemic, compared to 58% of severe patients. Doctors were more likely to discuss the importance of dental prevention with patients with severe IBDs (p = 0.0042).
Conclusions: Fewer patients with severe IBDs accessed regular dental care compared to their matched pair counterparts prior to the pandemic. This could indicate that access to care is more difficult for those with severe IBDs. Patients felt that oral health is relevant to their IBD. While doctors were more likely to discuss the importance of preventing dental disease with patients who have severe IBDs, the profession needs to ensure this translates into routine engagement.