The debate concerning oral anticoagulation: whether to suspend oral anticoagulants during dental treatment.
The management of patients taking long-term oral anticoagulants who require dental surgery is still highly controversial. The risk of bleeding associated with dental treatment under oral anticoagulants must be weighed against the risk of thromboembolism associated with suspension of antithrombotic therapy. Mortality and morbidity associated with thromboembolic events are higher than those associated with hemorrhagic events after minor oral surgery procedures. Evidence-based information does not support oral anticoagulant suspension before minor oral surgery. The authors propose a management protocol for chronically anticoagulated patients who require a dental procedure, to reduce both thromboembolic risk and the risk of bleeding.
António
Natália
N
Serviço de Cardiologia, Hospitals da Universidade de Coimbra, Coimbra, Portugal. natalia.antonio@gmail.com
Castro
Graça
G
Ramos
Domingos
D
Machado
António
A
Gonçalves
Lino
L
Macedo
Tice
T
Providência
Luís A
LA
D000925:Anticoagulants / Q000008:administration & dosage* / Q000009:adverse effects; D002985:Clinical Protocols; D006801:Humans; D019647:Oral Surgical Procedures; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage / Q000009:adverse effects
D000925:Anticoagulants; D014859:Warfarin