Audit of referrals of patients on oral antithrombotic therapy to a hospital oral surgery service for simple tooth extractions

Objective To assess the proportion of patients referred to a hospital oral surgery department for procedures that could have been managed in primary care. Method This cross-sectional audit included 41 outpatients on oral antithrombotic therapy who were referred to the University Hospital Dubrava in Zagreb, Croatia, for simple tooth extraction(s). Information about additional factors that may affect the complexity of the intervention was collected using a questionnaire. Any instructions regarding patients’ antithrombotic therapy regimens were also recorded. An oral surgeon evaluated whether each surgical procedure could have been safely performed in primary care. Results The oral surgeon estimated that in 75.6% (31/41) of the cases, the indicated extractions could have been safely managed in primary care, provided the clinician had relevant training and confidence. Instructions to discontinue antithrombotic therapy prior to the procedure were frequently encountered and, in most cases, issued by the patients’ dentists. Conclusion The findings of this study support the need for more comprehensive studies on the quality, appropriateness and underlying reasons for referrals to oral surgery departments. Such research would provide evidence to guide the development and implementation of measures aimed to enhance dentists’ clinical skills, self-confidence, and interdisciplinary collaboration, ultimately improving patient care.