Thrombophilia and dental surgery: a report of dental extraction in a patient with protein S deficiency.
Most patients with thrombophilia are asymptomatic. A case is presented here of a young woman with protein S deficiency, one of the thrombophilias, who required dental extraction. Protein S deficiency predisposes a very small number of those affected to life-threatening thromboses and emboli, for which they are required to take lifelong prophylactic anticoagulation. This report emphasizes the need to liaise closely with haematology departments when deciding whether heparinization is required for patients already taking warfarin. The role of low-molecular-weight heparins is highlighted, a brief review of thrombophilia is given and the management of patients who are taking warfarin and need dental surgery is discussed.
Crean
S J
SJ
Department of Maxillofacial Surgery, Dental School, University Hospital of Wales, Cardiff.
Sivarajasingam
V
V
Muhammed
J
J
Sharma
V
V
Fardy
M
M
D000328:Adult; D000925:Anticoagulants / Q000008:administration & dosage / Q000627:therapeutic use; D018890:Chemoprevention; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage / Q000627:therapeutic use; D005500:Follow-Up Studies; D006493:Heparin / Q000008:administration & dosage / Q000627:therapeutic use; D006495:Heparin, Low-Molecular-Weight / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D019934:International Normalized Ratio; D010314:Partial Thromboplastin Time; D018455:Protein S Deficiency / Q000150:complications* / Q000188:drug therapy; D012307:Risk Factors; D019851:Thrombophilia / Q000150:complications* / Q000517:prevention & control; D000078222:Tinzaparin; D014081:Tooth Extraction / Q000379:methods*; D014859:Warfarin / Q000008:administration & dosage / Q000627:therapeutic use
D000925:Anticoagulants; D005343:Fibrinolytic Agents; D006495:Heparin, Low-Molecular-Weight; D014859:Warfarin; D000078222:Tinzaparin; D006493:Heparin