## 3 Results
### Changes in Oral Health Habits of Young Patients with Hemophilia  
Of the 14 items in the questionnaire, only three items--\"whether or not floss is used\", \"frequency of brushing by parents (every day, several times a week, rarely, never)\", and \"presence of a family dentist\"--showed evident changes resulting from continual dental support and were associated with periodontal disease status. Therefore, we decided to focus on these three items for further analysis. Details of the questionnaire results are shown in Tables 4 and 5. \begin{table}
\begin{tabular}{l} \hline
1. What is your sex and age? \\
2. What is the type of hemophilia and the age of onset? \\
3. What is your recent clotting factor activity value? \\
4. How many times have you visited the comprehensive outpatient clinic for children \\ with hemophilia? \\
5. Is there any current preliminary and regular replacement therapy? \\
6. Do you have a family physician, and how many times have you seen the physician per year? \\
7. Have your family physician explained the importance of regular dental checkup? \\
8. How often do you brush your teeth? (every day, several times a week, rarely, never) \\
9. How many times do you brush your teeth per day? \\
10. Do you use dental floss? \\
11. How often do parents brush their children’s teeth with hemophilia? (every day, several times a week, rarely, never) \\
12. Have you received a fluoride application? \\
13. Have you received any experience of tooth brushing instruction? \\
14. Have you visited your family dentist? \\ \hline \end{tabular}
\end{table} 
Table 2: Questionnaire items. \begin{table}
\begin{tabular}{c c c c c c c} \hline \hline
**Stage** & **Sites of the Dentition** & **1 st Visit** & **2 nd Visit** & **3 rd Visit** & **4 th Visit** & **5 th Visit** \\ \hline \multirow{4}{*}{Mixed dentition} & Upper right molar & 1.75 \(\pm\) 0.49 & 0.50 \(\pm\) 0.22 ** & 0.75 \(\pm\) 0.49 & 0.89 \(\pm\) 0.31 & 0.45 \(\pm\) 0.16 * \\  & Upper central incisor & 0.67 \(\pm\) 0.21 & 0.67 \(\pm\) 0.21 & 0.38 \(\pm\) 0.18 & 0.67 \(\pm\) 0.33 & 0.27 \(\pm\) 0.14 \\  & Upper left molar & 0.50 \(\pm\) 0.19 & 0.50 \(\pm\) 0.22 & 0.50 \(\pm\) 0.19 & 0.78 \(\pm\) 0.15 & 0.82 \(\pm\) 0.12 \\  & Lower right molar & 0.50 \(\pm\) 0.19 & 0.50 \(\pm\) 0.22 & 0.50 \(\pm\) 0.19 & 1.00 \(\pm\) 0.29 * & 0.73 \(\pm\) 0.27 \\  & Lower central incisor & 1.13 \(\pm\) 0.30 & 0.83 \(\pm\) 0.40 & 0.25 \(\pm\) 0.16 * & 0.89 \(\pm\) 0.31 & 0.18 \(\pm\) 0.12 ** \\  & Lower left molar & 0.88 \(\pm\) 0.35 & 0.67 \(\pm\) 0.21 & 0.38 \(\pm\) 0.18 & 0.56 \(\pm\) 0.18 & 0.64 \(\pm\) 0.15 \\ \hline \multirow{4}{*}{Permanent} & Upper right molar & 1.27 \(\pm\) 0.18 & 1.50 \(\pm\) 0.33 & 1.34 \(\pm\) 0.38 & 0.86 \(\pm\) 0.14 ** & 1.00 \(\pm\) 0.00 \\  & Upper central incisor & 0.67 \(\pm\) 0.13 & 0.88 \(\pm\) 0.13 & 0.50 \(\pm\) 0.19 & 1.00 \(\pm\) 0.00 & 0.63 \(\pm\) 0.18 \\ \cline{1-1}  & Upper left molar & 1.07 \(\pm\) 0.15 & 1.63 \(\pm\) 0.53 & 1.25 \(\pm\) 0.41 & 1.00 \(\pm\) 0.38 & 1.25 \(\pm\) 0.25 \\ \cline{1-1}  & Lower right molar & 1.00 \(\pm\) 0.17 & 1.38 \(\pm\) 0.38 & 1.00 \(\pm\) 0.33 & 1.29 \(\pm\) 0.29 & 1.25 \(\pm\) 0.25 \\ \cline{1-1}  & Lower central incisor & 0.73 \(\pm\) 0.18 & 0.88 \(\pm\) 0.23 & 1.13 \(\pm\) 0.35 & 0.71 \(\pm\) 0.18 & 1.50 \(\pm\) 0.19 * \\ \cline{1-1}  & Lower left molar & 1.20 \(\pm\) 0.20 & 1.38 \(\pm\) 0.38 & 0.88 \(\pm\) 0.35 & 1.29 \(\pm\) 0.29 & 1.00 \(\pm\) 0.00 \\ \hline \hline \end{tabular}  
* The data are shown as the mean \(\pm\) SE. Statistical comparisons were performed on the same teeth in each dentition.
* \(p\) < 0.05 and *
* \(p\) < 0.01 versus 1 st visit;
* \(p\) < 0.05 versus 2 nd visit;
* \(p\) < 0.05 versus 3 rd visit;
* \(p\) < 0.05 versus 4 th visit.  
\end{table} 
Table 3: Community Periodontal Index (CPI) values for different sites of the dentition in young patients with hemophilia. Figure 2: CPI values in young patients with hemophilia. (**A**) Mixed dentition. (**B**) Permanent dentition. Each black circle indicates the CPI value for each subject. Bars indicate mean and SE.