Dental Procedures: Managing Blood Thinners

Regarding #NOACs or new oral anticoagulants like rivaroxaban, apixaban and dabigatran, a four-year cross-sectional study found no significant bleeding associated with the continuation of #anticoagulation during #dental_procedures, irrespective of their invasiveness. Despite the absence of a specific antidote for dabigatran, its short half-life allows for a prompt reversal of anticoagulation if necessary. Additionally, an examination of the EINSTEIN studies demonstrated that #rivaroxaban, another NOAC, resulted in fewer major hemorrhagic events compared to warfarin/bridging therapy in the treatment of deep venous thrombosis and pulmonary embolism.
The American Dental Association recommends maintaining anticoagulation for most dental procedures, unless the patient is at an exceptionally high risk of bleeding, in which case consulting a physician before the procedure may be advisable.
Conclusion: In most dental procedures, it's essential to continue vitamin K antagonists (VKAs) and non-vitamin K antagonist oral anticoagulants (NOACs). Utilize local hemostatic agents and monitor INR levels and renal function closely. Interrupting and restarting oral anticoagulation can pose challenges for both patients and physicians, potentially raising the risk of thromboembolic events. A multidisciplinary approach is recommended for the best management.