Why the study?
Does continuing anticoagulation or antiplatelet therapy safely prevent thromboembolism without excessive hemorrhage in patients undergoing minor oral surgery?
Does continuing anticoagulation or antiplatelet therapy safely prevent thromboembolism without excessive hemorrhage in patients undergoing minor oral surgery?
Minor oral surgical procedures can be safely performed in patients on anticoagulation with an INR lower than 4.0 without stopping therapy.
Answers are grounded in this paper and cite their sources.
Supports continuing anticoagulation for minor oral surgery with INR <4.0; leaves open confirmation in prospective trials.
Antiplatelet and anticoagulant agents have been extensively researched and developed as potential therapies in the prevention and management of arterial and venous thrombosis. On the other hand, antiplatelet and anticoagulant drugs have also been associated with an increase in the bleeding time and risk of postoperative hemorrhage. Because of this, some dentists still recommend the patient to stop the therapy for at least 3 days before any oral surgical procedure. However, stopping the use of these drugs exposes the patient to vascular problems, with the potential for significant morbidity. This article reviews the main antiplatelet and anticoagulant drugs in use today and explains the dental management of patients on these drugs, when subjected to minor oral surgery procedures. It can be concluded that the optimal INR value for dental surgical procedures is 2.5 because it minimizes the risk of either hemorrhage or thromboembolism. Nevertheless, minor oral surgical procedures, such as biopsies, tooth extraction and periodontal surgery, can safely be done with an INR lower than 4.0.
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Pototski et al. (2007) studied this question.
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