Dental treatment for the patient on anticoagulant therapy: Prothrombin time value—what difference does it make?

Benoliel, Rafael; Leviner, E.; Katz, Joseph; Tzukert, A.

doi:10.1016/0030-4220(86)90036-8

Cited by 32 publications

(16 citation statements)

References 21 publications

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“…5,11,57,61 On the other hand, a single dental extraction has been called "a significant stress to the hemostatic mechanisms." 62 Some recommend that anticoagulation therapy be reduced or withdrawn until PT or INR is near normal (PT within 1.5 times control) 63,64 or even normal 65 before dental surgery.…”

Section: Analysis Of 12 Documented Cases Of Postoperative Hemorrhage mentioning

confidence: 99%

“…66 Several investigators have stated that postoperative bleeding after dental extractions is minimal at or above present therapeutic PT ratios (PT up to 2.5 times the control). 5,67,68 Since dental extractions have been called a "significant" or even "severe" challenge to hemostasis, some assume that dental extractions in anticoagulant-treated patients present more bleeding problems than in patients not taking anticoagulants. But even patients with normal coagulation undergoing dental surgery may have postoperative hemorrhage.…”

Section: Analysis Of 12 Documented Cases Of Postoperative Hemorrhage mentioning

confidence: 99%

“…[7][8][9][10][11] The focus of this article is to review only surgical dental procedures (extractions, gingival surgery, and alveolar surgery): nonsurgical dental procedures (professional cleanings, fillings, crowns, etc) have been shown not to present a significant bleeding risk. 5 In a 1995 survey, the majority (73%) of practicing physicians recommended withdrawing therapeutic continuous warfarin therapy in some patients for at least some dental procedures. 12 Instead of changing the patient's prothrombin time, it is time to change the practice of withdrawing anticoagulant treatment for dental surgery.…”

mentioning

confidence: 99%

“…Some recommend no change in anticoagulation for dental treatment. 5,6 Others recommend withdrawal of oral anticoagulant therapy for several days before the procedure and consideration of therapeutic administration of heparin for certain high-risk patients and high-risk dental procedures. [7][8][9][10][11] The focus of this article is to review only surgical dental procedures (extractions, gingival surgery, and alveolar surgery): nonsurgical dental procedures (professional cleanings, fillings, crowns, etc) have been shown not to present a significant bleeding risk.…”

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confidence: 99%

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Dental Surgery in Anticoagulated Patients

Wahl¹

1998

Arch Intern Med

342

164

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Section: Analysis Of 12 Documented Cases Of Postoperative Hemorrhage mentioning

confidence: 99%

Section: Analysis Of 12 Documented Cases Of Postoperative Hemorrhage mentioning

confidence: 99%

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confidence: 99%

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confidence: 99%

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Dental Surgery in Anticoagulated Patients

Wahl¹

1998

Arch Intern Med

342

164

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“…Il n'y a pas d'hospitalisation du patient et une hémostase locale de niveau 1 est réalisée. Il n'y a pas de protocole clairement décrit dans la littérature et, pour le calcul, nous nous sommes appuyés sur plusieurs articles [4,5,6] …”

Section: Interruption Du Traitement Avkunclassified

Etude du rapport coût/sécurite lors de la prise en charge des patients sous antivitamines K en chirurgie buccale

Conan

Massot

Clipet

et al. 2009

Med Buccale Chir Buccale

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RÉSUMÉAvant un acte de chirurgie buccale, trois attitudes cliniques sont possibles face aux patients hypocoagulés par antivitamines K (AVK) : maintenir le traitement, l'arrêter ou réaliser un relais héparinique. Quelques mois après la publication par la Société Francophone de Médecine Buccale et de Chirurgie Buccale (SFMBCB) en accord avec la Société Française de Cardiologie (SFC) de recommandations pour la prise en charge de patients sous AVK en chirurgie buccale, cette étude évalue ces recommandations en terme de rapport coût/sécurité. La simulation des coûts globaux de la prise en charge des patients sous AVK pour l'extraction d'une dent incluse réalisée dans ce travail semble montrer une différence entre les attitudes cliniques publiées dans la littérature. Il semble plus coûteux de traiter des patients à risque hémorragique important que des patients à risque hémorragique plus faible. Intervenir sans modification du traitement, attitude la plus sûre pour le patient, semble également la moins onéreuse. Lors de la réalisation d'un relais aux héparines, le protocole le plus éco-nomique est d'utiliser des héparines de bas poids moléculaire administrées par une infirmière à domicile. L'hospitalisation pour un relais avec des héparines non-fractionnées administrées par voie intraveineuse continue chez le patient à risque thrombotique très important semble être l'attitude la plus onéreuse. L'interruption du traitement AVK expose le patient à des risques d'accidents thromboemboliques potentiellement gravissimes ; cette attitude clinique n'est pas la moins coûteuse. Ainsi, le rapport coût/sécurité de « l'absence de modification du traitement » est largement positif tandis que celui de « l'interruption du traitement » est largement négatif. Article originalEtude du rapport coût/sécurite lors de la prise en charge des patients sous antivitamines K en chirurgie buccale

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Bleeding and Clotting Disorders

Napeñas¹,

Patton²

2021

Burket's Oral Medicine

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Dental health care workers are increasingly called upon to provide quality dental care to individuals whose bleeding and clotting mechanisms have been altered by inherited or acquired diseases. This provides an opportunity for the dentist who is trained in the recognition of oral and systemic signs of altered hemostasis to assist in the diagnosis of the underlying condition. A number of dental procedures result in the risk of bleeding that can have serious consequences, such as severe hemorrhage or possibly death, for the patient with a bleeding disorder. Safe dental care may require consultation with the patient's physician, systemic management, and dental treatment modifications.Of the inherited coagulopathies, von Willebrand's disease (vWD) is the most common. It results from deficiency of von Willebrand's factor (vWF) and affects about 0.8 to 1% of the population. 1 Hemophilia A, caused by coagulation factor (F) VIII deficiency, is the next most common, followed by hemophilia B, a F IX deficiency. The age-adjusted prevalence of hemophilia in six surveillance states in 1994 was 13.4 cases in 100,000 males (10.5 for hemophilia A and 2.9 for hemophilia B). 2 Application to the US population resulted in an estimated national prevalence of 13,320 cases of hemophilia A and 3,640 cases of hemophilia B, with an incidence rate of 1 per 5,032 live male births. Hemophilia A was predominant, accounting for 79% of all hemophiliacs, and prevalence of disease severity was 43% severe (< 1% F VIII), 26% moderate (1-5% F VIII), and 31% with mild (6-30% F VIII) disease. 2 Acquired coagulation disorders can result from drug actions or side effects, or underlying systemic disease. A stratified household sample of 4,163 community residents aged 65 years or older living in a five-county area of North Carolina revealed 51.7% to be taking one or more medications (aspirin, warfarin, dipyridamole, nonsteroidal anti-inflammatory drugs

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Dental treatment for the patient on anticoagulant therapy: Prothrombin time value—what difference does it make?

Cited by 32 publications

References 21 publications

Dental Surgery in Anticoagulated Patients

Dental Surgery in Anticoagulated Patients

Etude du rapport coût/sécurite lors de la prise en charge des patients sous antivitamines K en chirurgie buccale

Bleeding and Clotting Disorders

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