title: Risk of postoperative bleeding after dental procedures in patients on warfarin: a retrospective study.
abstract: OBJECTIVE
  The purpose of this retrospective study was to investigate the frequency of bleeding complications after invasive dental procedures in warfarinized patients and the possible risk factors.
  
  
  METHODS
  The CoaguChek System was used to obtain an in-office international normalized ratio (INR) value for 122 patients (240 appointments), of which the mean age was 57.0 ± 15.9 years and 50% were males. Demographic and clinical information were obtained retrospectively from dental and medical records.
  
  
  RESULTS
  Five episodes (mean INR: 2.0 ± 0.8) of persistent bleeding were identified; 4 were after extractions and 1 was after implant placement. The frequency of bleeding was 4.8%, if only considering surgical procedures. Postoperative bleeding was significantly higher (P < .05) in patients who were taking anti-thrombotic medications in addition to warfarin.
  
  
  CONCLUSIONS
  There is a low incidence of persistent bleeding after invasive dental procedures in warfarinized patients but the risk appears to increase with the use of concomitant anti-thrombotic medications.
authors.affiliation: Division of Orthodontics and Pediatric Dentistry, Faculty of Dentistry, National University of Singapore, Singapore. denchhl@nus.edu.eg
authors.forename: Catherine
authors.initials: C
authors.lastname: Hong
authors.forename: Joel J
authors.initials: JJ
authors.lastname: Napenas
authors.forename: Michael
authors.initials: M
authors.lastname: Brennan
authors.forename: Scott
authors.initials: S
authors.lastname: Furney
authors.forename: Peter
authors.initials: P
authors.lastname: Lockhart
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D015994:Incidence; D019934:International Normalized Ratio; D008297:Male; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000453:epidemiology*; D019647:Oral Surgical Procedures; D019106:Postoperative Hemorrhage / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D014859:Warfarin / Q000008:administration & dosage*
chemical_list: D000925:Anticoagulants; D014859:Warfarin