title: Sharp tooth induced sublingual hematoma in a patient with elevated international normalized ratio.
abstract: Sublingual hematoma secondary to anticoagulation is a rare fatal condition. Hemorrhagic complications of warfarin are well-known. This particular case is unique because the patient was on warfarin for the past 2 years but did not develop the sublingual hematoma. However, a trauma by an attrited sharp cusp triggered the episode of the sublingual hematoma in this patient. Being a medical emergency, patient was promptly hospitalized in cardiac care unit and managed by medical team. The patient was transfused with 2 units of fresh frozen plasma and warfarin was temporarily stopped for 4 days. Alternate day regimen of warfarin was started after 4 days, and international normalized ratio dropped to 3. In dental management, enameloplasty of the mandibular first molar tooth was done to prevent trauma and ulcer development in the floor of the mouth. The hematoma resolved, and no new hematoma formation was observed for a period of 6 months.
authors: Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, Puducherry, India.
authors: John
authors: J
authors: Baliah
authors: Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, Puducherry, India.
authors: Kayalvizhi
authors: Department of Oral Medicine and Radiology, Indira Gandhi Institute of Dental Sciences, Puducherry, India.
authors: Vishwanath
authors: V
authors: Rangdhol
authors: Department of Prosthodontics, Indira Gandhi Institute of Dental Sciences, Puducherry, India.
authors: David
authors: D
authors: Livingstone
keywords: Enameloplasty; international normalized ratio; sublingual hematoma