Tranexamic acid mouthrinse (10%) effectively controlled postextraction bleeding in patients on anticoagulant and antiplatelet therapy, with only 16% experiencing oozing that was managed locally.
Does 10% tranexamic acid mouthrinse prevent uncontrolled postextraction bleeding in patients on anticoagulant and antiplatelet therapy?
The use of 10% tranexamic acid mouthrinse is a safe and effective local hemostatic measure for managing dental extractions in patients on anticoagulant therapy with an INR between 1.9 and 3.5, avoiding the need to alter systemic antithrombotic regimens.
BACKGROUND: Patient who is on antiplatelet therapy had an impaired fibrin formation which leads to fibrinolysis which is the main reason behind postextraction bleeding. OBJECTIVES: The aim of the study is to manage anticoagulated patient who has to undergo dental extraction by using hemostatic agent and the objective is to rule out potential risk factor which may trigger bleeding. METHODS: One hundred patients with anticoagulant and antiplatelet therapy and having International Normalized Ratio (INR) in-between 1.9 and 3.5 were selected. Postextraction instruction use 5 ml of 10% tranexamic acid mouthrinse four times a day for next 7 days was suggested. All demographic data, history of anticoagulant and antiplatelet therapy, details of bleeding, and treatment requirement were recorded to identify potential risk factor. RESULTS: Of 100 subjects, 16 were reported postextraction bleeding on days 1 and 2 which was controlled by tranexamic acid pressure pack. Bleeding from extraction socket of 10 patients was stopped by gelatin foam. No life-threatening risk was observed. In patients with age group of 41-60 years whose INR value was ≥2.5, the number of teeth undergoing extraction, whose bleeding time was increased, and were on long duration of antiplatelet and anticoagulation therapy might increase the risk of bleeding. CONCLUSION: Use of tranexamic acid mouthrinse after extraction is an effective way to control bleeding on patients who are under antiplatelet therapy with at therapeutic INR level is a secure and allowable method of minimizing postextraction oozing.
Jaiswal et al. (Tue,) conducted a other in Patients on anticoagulant and antiplatelet therapy undergoing dental extraction (n=100). Tranexamic acid mouthrinse was evaluated on Postextraction bleeding. Tranexamic acid mouthrinse (10%) effectively controlled postextraction bleeding in patients on anticoagulant and antiplatelet therapy, with only 16% experiencing oozing that was managed locally.