title: Treating dental patients who use oral antithrombotic medication: a survey of dentists in the Netherlands.
abstract: BACKGROUND
  For many years, international guidelines have advised health care professionals not to adjust oral antithrombotic medication (OAM) regimens before invasive dental procedures. The authors conducted a study to examine the opinions of Dutch general dentists regarding the dental care of patients receiving treatment with these medications.
  
  
  METHODS
  The authors invited via e-mail 1,442 general dentists in the Netherlands to answer a 20-item Internet-based questionnaire that they developed. Survey items consisted of questions about medical history taking, number of patients in the dental practice receiving OAM therapy, frequency of consulting with medical and dental colleagues and suggested dental treatment of patients during various invasive dental procedures.
  
  
  RESULTS
  A total of 487 questionnaires were returned (response rate of 34 percent). The mean age of respondents was 47 years, and 77 percent were male. The majority of dentists responded that they obtain medical histories, but that they did not know how many of their patients were receiving OAM treatment. Dentists reported that they consult with medical colleagues frequently about antithrombotic medication. Ninety-one percent of respondents stated that they obtained their medical knowledge primarily in dental school. More than 50 percent of the dentists reported that they were not familiar with the international normalized ratio. The majority of dentists responded that they felt a need for clinical practice guidelines.
  
  
  CONCLUSIONS
  According to the results of our survey, most dentists remain cautious when performing invasive dental procedures in patients who are treated with OAMs. Moreover, survey respondents tended to estimate that the risk of bleeding during dental procedures when OAM therapy is continued is higher than the risk of rethrombosis when use of antithrombotic medication is interrupted.
  
  
  CONCLUSIONS
  A growing proportion of elderly patients and those with medically complex conditions are being treated in dental practices in the Netherlands. Consequently, more needs to be done to ensure that dentists are offered evidence-based guidance when treating patients who receive OAMs.
authors: Department of Oral and Maxillofacial Surgery, Medical-Dental Interaction, Academic Center for Dentistry, Gustav Mahlerlaan 3004, room 12N41, 1081 LA Amsterdam, the Netherlands. d.v.diermen@acta.nl
authors: Denise E
authors: DE
authors: van Diermen
authors: Josef J M
authors: JJ
authors: Bruers
authors: Johan
authors: J
authors: Hoogstraten
authors: Marieke
authors: M
authors: Bovenlander
authors: Albertine
authors: A
authors: van den Bosch
authors: Isaäc
authors: I
authors: van der Waal
mesh_terms: D000284:Administration, Oral; D001291:Attitude of Health Personnel; D017742:Dental Care for Chronically Ill; D012534:Dental Scaling; D004497:Education, Dental; D034742:Electronic Mail; D005260:Female; D005343:Fibrinolytic Agents / Q000008:administration & dosage*; D005792:General Practice, Dental / Q000193:education; D006801:Humans; D019934:International Normalized Ratio; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D009426:Netherlands; D006472:Oral Hemorrhage / Q000209:etiology; D010820:Physicians; D017410:Practice Guidelines as Topic; D019239:Practice Patterns, Dentists'; D012017:Referral and Consultation; D012307:Risk Factors; D012390:Root Canal Therapy; D011795:Surveys and Questionnaires; D013927:Thrombosis / Q000209:etiology; D014081:Tooth Extraction
chemical_list: D005343:Fibrinolytic Agents