Bleeding Rate After Tooth Extraction in Patients Under Oral Anticoagulant Therapy

Area of Science:

• Cardiology
• Oral Surgery
• Pharmacology

Background:

• Cardiovascular disorders are common, often requiring oral anticoagulant therapy.
• Tooth extraction in patients on anticoagulants necessitates careful risk assessment for bleeding.
• International Normalized Ratio (INR) monitoring is standard for oral anticoagulant therapy.

Purpose of the Study:

• To assess the bleeding risk associated with tooth extractions in patients with cardiovascular disorders on oral anticoagulants (INR ≤ 3.0).
• To identify specific patient and procedural factors influencing bleeding events.

Main Methods:

• Prospective study of 293 patients undergoing 560 tooth extractions.
• Extraction sockets managed with collagen tablets and sutures.
• Bleeding risk evaluated based on anticoagulant type (acenocoumarol/warfarin), cardiovascular disease type, and number of extractions.

Main Results:

• Overall bleeding event rate was 6.8%.
• Higher bleeding rates observed in patients with multiple (more than 2) tooth extractions compared to single extractions (P < 0.05).
• Bleeding events occurred in patients with valvular disorders, arrhythmias, and cardiomyopathies.

Conclusions:

• Multiple tooth extractions increase bleeding risk in patients on oral anticoagulants.
• Patients on acenocoumarol and with multiple cardiovascular conditions are at elevated risk.
• Risk stratification is essential for safe dental procedures in this patient group.