Management of the anticoagulated patient in dental surgery.
DOI:
https://doi.org/10.35954/SM2022.41.2.7.e404Keywords:
Anticoagulant; Tooth extraction; Hemorrhage; Hemostásis; Dentistry; Oral Surgical Procedures; Thrombosis; Warfarin.Abstract
Introduction: Adequate hemostasis is crucial for the success of invasive dental treatment, since bleeding problems can lead to complications associated with significant morbidity and mortality. The dental treatment of patients who are prone to an increased risk of bleeding due to the use of anticoagulant drugs poses a challenge in the daily practice of dental professionals. Adequate knowledge of the mechanisms underlying hemostasis and optimized management of these patients are therefore very important issues. A review is made of the anticoagulant drugs currently available on the market, evaluating the risks and benefits of suspending such a drug prior to invasive dental treatment. In addition, a review is made of the current management protocols used in these patients.
Material and methods: A bibliographic search was carried out in the Epistemonikos and Medline/PubMed databases; in the Timbo portal and in the Scielo virtual library. All the studies published in the last 15 years in English and Spanish were included. Thirty articles were found, 15 were selected in the first instance to end up with 11 articles. In this selection, the filter was that the other articles referred to other anticoagulants that were not part of this work.
Results: multiple management protocols have been developed, although in all cases a complete clinical history is required, together with complementary hemostatic tests to minimize the risks derived from dental treatment.
Discussion: many authors consider that the patient's medication indicated for the treatment of an underlying disease should not be altered or suspended unless so indicated by the prescribing physician. It has been shown that local hemostatic measures are sufficient to control possible bleeding problems derived from dental treatment.
Received for review: April 2022.
Accepted for publication: July 2022.
Correspondence: Del Pilar 226. Melo, Uruguay. C.P 37000. Tel: (+598) 46423664.
Contact e-mail: paolasequeirarivero1@gmail.com
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