Key result
Direct oral anticoagulants provide effective anticoagulation with a similar or better bleeding profile compared to warfarin, though concerns remain for their use in frail elderly dental patients.
This review highlights considerations for managing dental treatments in frail elderly patients taking direct oral anticoagulants.
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May inform DOAC management in dental procedures; leaves open optimal periprocedural strategies pending prospective data.
Direct oral anticoagulants (DOACs) have led to a paradigm shift in the field of anticoagulation, providing safe and convenient anticoagulation without the need for regular blood testing. Currently, there are three major DOACs available-Factor Xa inhibitors (apixaban and rivaroxaban) and direct thrombin inhibitors (dabigatran)-that are available for use in atrial fibrillation and venous thromboembolism. While these agents have been shown to be as effective as warfarin, with a similar or better bleeding profile, there remains some concern of the use of these drugs in vulnerable populations, such as the frail elderly patients; particularly since reversal agents and drug monitoring are not routinely available. We aim to provide a review of the use of DOACs and the impact of DOACs on dental treatment in the elderly population.
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Lim et al. (2016) conducted a review in Atrial fibrillation, venous thromboembolism, and dental treatment. Direct oral anticoagulants (DOACs) vs. Warfarin was evaluated. Direct oral anticoagulants provide effective anticoagulation with a similar or better bleeding profile compared to warfarin, though concerns remain for their use in frail elderly dental patients.
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