the pain in adults can usually be controlled by removing pulp from the tooth.In paediatric patients local anesthesia is used as for any other patient who presents with acute pulpitis. If patients cannot tolerate this treatment an urgent referral to a specialist paediatric unit is required as use of sedation or general anesthesia may be indicated. A temporary dressing should be used if the tooth is not restorable and the haemophilia centre contacted for planning of the extraction