We evaluated the effectiveness of
desmopressin to control
bleeding of patients with coagulation defects during dental surgery. Thirty-five patients, mainly with moderate and mild
hemophilia and Willebrand disease, were undergoing dental extractions (over 80 extractions in total).
Bleeding was successfully prevented in 28 patients with the use of a combined treatment incorporating IV
desmopressin, an
antifibrinolytic agent (
tranexamic acid), and local methods (surgical glue and compression techniques). Seven patients had a
bleeding episode after dental extraction, which was controlled in two cases by repeated injection of
desmopressin and in another two by local methods;
Factor VIII substitutive treatment was needed in only three patients.
Desmopressin offers an alternative to blood products to control
bleeding risk in patients with moderate and mild coagulation defects. Our experience tends to specify the mode of administration of both
desmopressin and the associated treatments. Our findings suggest that
desmopressin can be used in conjunction with other treatments to prevent
bleeding in patients with coagulation defects who undergo dental surgery. This work highlights the concept of multifactorial medical care of these patients in which
desmopressin plays a major role.