The teeth can be significantly affected in patients with thalassemia, but proper transfusion therapy can prevent many of the changes. However, close dental and orthodontic monitoring is crucial. In addition to regular annual dental care, thalassemia patients should be evaluated by a dentist to determine if bony changes requiring orthodontic treatments have developed. If orthodontics are recommended, they will be covered by insurance, since their necessity is disease-related.
Furthermore, splenectomy can complicate dental care due to increased risk of infection. Prior to dental work, which is likely to cause bleeding of the gums, splenectomized patients should receive dental prophylaxis. Recommended treatment is 50 mg/kg of amoxicillin (to a maximum dose of 2 g) one hour prior to dental work. If the patient is allergic to penicillin, 20 mg/kg of clindamycin (to a maximum dose of 600 mg) should be administered one hour prior to procedure.