Key result
Continuing antithrombotics is safe for most dental procedures, with bleeding managed by local hemostatic measures.
Why the study?
The implications of traditional and novel anti-thrombotic medications on bleeding risk and management during invasive outpatient dental procedures require clarification.
Does continuation of anti-thrombotic therapy increase significant post-procedure bleeding in patients undergoing invasive outpatient dental procedures?
Does continuation of anti-thrombotic therapy increase significant post-procedure bleeding in patients undergoing invasive outpatient dental procedures?
Routine discontinuation of anti-thrombotic medications is not required for most outpatient dental procedures, though individualized risk assessment is recommended.
Answers are grounded in this paper and cite their sources.
Supports continuation of antithrombotics for most dental procedures; leaves open need for prospective RCTs to guide practice.
This article reviews the implications of traditional and novel anti-thrombotic medications in dentistry, focusing on areas relating to the prevalence of significant post procedure bleeding, measures that should be taken to minimize and manage bleeding; and current opinions regarding need for alteration of anti-thrombotic regimens prior to dental procedures in dentistry.Based on the current literature, discontinuation of anti-platelet medications, warfarin therapy, dabigatran and Factor Xa inhibitors is not needed in majority of in office dental procedures.However, it is important that treating clinician must use discretion based on the patient's risk profile (e.g.presence of comorbidities) and extensiveness of planned dental procedures to assess each patient's risk for significant bleeding.
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Hong Ch (2013) conducted a review in Patients on anti-thrombotic therapy undergoing dental procedures. Continuation of anti-thrombotic therapy vs. Discontinuation or alteration of therapy was evaluated on Significant post-procedure bleeding. Continuation of anti-platelet medications, warfarin (INR ≤ 4), and novel oral anticoagulants is safe for most in-office dental procedures, as bleeding can be managed with local hemostatic measures.
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