Dental management of patients receiving anticoagulation or antiplatelet treatment.
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.
Pototski
Mariele
M
School of Dentistry, University of Minnesota, St Paul, MN, USA.
Amenábar
José M
JM
D000925:Anticoagulants / Q000627:therapeutic use*; D001777:Blood Coagulation / Q000502:physiology; D017742:Dental Care for Chronically Ill; D006489:Hemostatic Techniques; D006801:Humans; D019934:International Normalized Ratio; D006472:Oral Hemorrhage / Q000209:etiology / Q000517:prevention & control; D019647:Oral Surgical Procedures / Q000009:adverse effects; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000517:prevention & control; D013927:Thrombosis / Q000517:prevention & control
D000925:Anticoagulants; D010975:Platelet Aggregation Inhibitors