ABSTRACT

Providing dental care to patients with systemic comorbidities is difficult as they are on multi drug therapy. One such drug or group of drugs, which require modification in dosing and administration especially during invasive dental treatments, are anticoagulants.Extractions should be done with caution in patients under anticoagulant therapy as it is associated with escalated chances of profuse bleeding and complications associated with morbiditymortality. To identify, appraise the available evidence on bleeding related to dental treatment in patients with thromboembolic disorders taking two groups of oral anticoagulants – the new/ novel oral anticoagulants and the other conventional oral anticoagulants an electronic search in various databases was performed. Articles were selected if they were studies which evaluated the effect of anticoagulants on peri-, and post-operative bleeding related to dental procedures in patients under NOACs and other oral anticoagulants. The electronic and hand search of studiesyielded 7 studies meeting the inclusion criteria. The available evidence from the included studies show that NOACs are associated with mild to moderate post-operative bleeding with can be controlled by local hemostatic measures such as mechanical compression using gauze pads and collagen sponges. Severe bleeding requiring hospitalization was not reported in any of the included studies. For simple tooth extractions, the studies concluded that interrupting or dose alteration of NOACs was not required. FurtherRCTs have to be done to confirm the above mentioned conclusions and to form guidelines for carrying out invasive procedure in dental patients under NOACs. Keywords: novel oral anticoagulants, NOACs, direct oral anticoagulants, oral anticoagulants and warfarin
Publication date: 01/11/2020

https://ijbpas.com/pdf/2020/November/MS_IJBPAS_2020_5294.pdf

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https://doi.org/10.31032/IJBPAS/2020/9.11.5294