What is your clinical approach to oral surgery patients under anticoagulant therapy?

In general, for most routine dental extractions, no change in approach if they are in their therapeutic range i.e. don't stop their meds, use good local measures (Surgicel plus sutures).

http://www.bcshguidelines.com/documents/WarfarinandentalSurgery_bjh_264_2007.pdf

Are good guidelines from the British Committee for Standards in Haematology and

http://www.nature.com/bdj/journal/v203/n7/full/bdj.2007.892.html

is a paper from the British Dental Journal 2007 saying very similar things.

Best wishes,

Patrick M

Cagri Delilbasi

Thank you for your contribution

Jigar Dhuvad

If patient's PT, PTT and INR value are within normal range then you can proceed for the minor oral surgical procedure without disturbing the dose of antiplatelet. you can continue ur line of Rx even pt is on antiplatelet agents.

k.a Galil

I have recently done many surgeries on patients under anticoagulant therapy.I usually consult with their physician either a general practitioner or a specialist, all of them recommend That I ask the patient to stop the anticoagulant medication like eg Eliquis (Apixaban) "for 48 hours and if he is on aspirin stop it for 24 hours. i found that this procedure decreases the amount of bleeding. if this patient is also on blood pressure medication usual iI also ask him to make sure he takes his blood pressure medication on the day of surgery. following the surgery, the usual procedure of adding Gel foam plug(to coagulate the blood) and sutre is also carried by me.

a piece of advice: some patients tend to forget to follow the instructions so we make sure to phone them 2 days ahead of surgery to remind them, nothing is worst than a patient who comes to the clinic and forgot to do what you asked him to do and still insists o the surgery

Dr.K.A.Galil.Professor of Medicine and Professor of Dentistry DDS.,D.Oral & Maxillofacial Surgery ,PH.D,FAGD.,FADI.,Cert.Periodontist(Uof Michigan) (Royal College Dent Surg.Ont) Departments of Periodontics,Orthodontics and Clinical Anatomy Schulich School Of Medicine and Dentistry. University of Western Ontario, London,Ontario.

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