Assessment of extraction in patients on oral anticoagulant therapy with and without stopping the drug
Keywords:
oral anticoagulants, Tooth, DrugAbstract
Background: It is controversial whether or not oral anticoagulants should be stopped before extraction in patients using them. The present study was conducted to assess cases undergoing extraction in patients on oral anticoagulant therapy with and without stopping the drug.
Materials & Methods: 50 patients on oral anticoagulant therapy scheduled for dental extraction of both genderswere divided into 2 groups of 25 each. Group I patients were instructed to continue warfarin without any alteration of the dose prior to dental extractions, and group II patients were instructed to stop warfarin 3 days before extraction.
Results: Out of 50 patients, 30 were males and 20 were females. Tooth extracted were incisors in 4 in group I and 5 in group II, canine 2 in group I and 6 in group II, premolar 5 in group I and 4 in group II and molars 5 in group I and 4 in group II. The difference was non- significant (P> 0.05). The mean INR was 2.6 in group I and 1.4 in group II. The difference was significant (P< 0.05).
Conclusion: As long as the INR remains within the therapeutic range, post-extraction bleeding is not a significant issue for patients who continue oral anticoagulant medication without changing the dosage.
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Davies JA, Tuddenham EGD. Hemostasis and thrombosis. In: Weatherall DJ, Ledingham JGG, Warrell DA, editors. Oxford Textbook of Medicine. 2. Oxford: Oxford Medical Publications; 1988. pp. 228–229.
Pavek V, Bigl P. Stomatological treatment of patients with artificial heart valves: coagulation control and antibiotic cover. Int Dent J. 1993;43:59–61.
Mulligan R, Weitzel KG. Pretreatment management of the patients receiving anticoagulation drugs. J Am Dent Assoc. 1988;117:479–483.
Troulis MJ, Head TW, Lecter JR. Dental extraction in patients on oral anticoagulant: a survey of pratices in north America. J Oral Maxillofac Surg. 1998;56:914–917.
Little JW, Falace DA, Miller CS et al (2002) Bleeding disorder. In: Dental management of the medically compromised patient. Mosby, St Louis
Little JW, Miller CS, Henry RG, et al. Antithrombotic agents- implications in dentistry. Oral Surg Oral Med Oral Pathol. 2002;93:544.
Roser SM, Rosenbloom B. Continued anticoagulant in oral surgery procedures. Oral Surg Oral Med Oral Path. 1975;40:448–457.
Donoff RB. Massachusetts General Hospital Manual of Oral and Maxillofacial Surgery. CV Mosbv: St Louis; 1987. pp. 100–102.
Ahmed I, Younis M, Shah AA. Extraction in patients on oral anticoagulant therapy with and without stopping the drug: A comparative study. Journal of Maxillofacial and Oral Surgery. 2019 Dec;18:555-8.
Declerck D, Vinckier F, Vermylen J. Influence of anticoagulation on blood loss following dental extractions. Journal of dental research. 1992 Feb;71(2):387-90.
Martinowitz U, Mazar AL, Taicher S, et al. Dental extraction for patients on oral anticoagulant therapy. Oral Surg Oral Med Oral Pathol. 1990;70:274–277.
Madura JA, Rookstool M, Wease G. The management of patients on chronic Coumadin therapy undergoing subsequent surgical procedures. The American Surgeon. 1994 Jul 1;60(7):542-6
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