A 5-year-old child with hemophilia needs an extraction of tooth J. What will you do?

Correct answer: B. Consult a physician before proceeding

• A. Aspirin is absolutely contraindicated in hemophilia — it inhibits platelet function, dramatically worsening bleeding risk.
• B. Before extracting a tooth in a hemophiliac child, the dentist MUST consult with a physician/hematologist to determine current factor levels, appropriate factor replacement pre/post-operatively, and whether the procedure can safely be performed in an outpatient setting.
• C. The first step is consultation with the patient's hematologist — not outright refusal — to determine the appropriate setting and protocol.
• D. Proceeding without medical consultation is dangerous. Hemophilia patients require factor replacement prior to any invasive dental procedure.