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Managing patients taking edoxaban in dentistry.

Adrian Curto1, Daniel Curto2, Jorge Sanchez3

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Novel oral anticoagulants (NOACs) offer advantages over warfarin but lack specific reversal agents. Dental practitioners need guidance for managing patients on edoxaban, as its use increases and interruption is often unnecessary for minor procedures.

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Area of Science:

  • Pharmacology and Therapeutics
  • Dental Medicine

Background:

  • Novel oral anticoagulants (NOACs) are increasingly prescribed, offering advantages over traditional anticoagulants like warfarin.
  • Approved NOACs include edoxaban, dabigatran, rivaroxaban, and apixaban, known for predictable pharmacokinetics and fewer interactions.
  • A key limitation of NOACs is the absence of a specific reversal agent.

Purpose of the Study:

  • To review evidence on rivaroxaban and provide clinical guidance for dental practitioners.
  • To inform oral care clinicians about managing patients on edoxaban.
  • To highlight the need for evidence-based guidelines for dental patients on edoxaban.

Main Methods:

  • Literature search of PubMed and Cochrane Library up to July 2016.
  • Keywords included specific NOAC names, "new oral anticoagulants," "novel oral anticoagulants," "bleeding," and "dental treatment."
  • Focus on publications within the last 10 years.

Main Results:

  • Edoxaban use is rising, with no routine coagulation monitoring required.
  • Interruption of edoxaban is generally not necessary for minor oral surgery.
  • Dentists must accurately assess patients on anticoagulation therapy before dental procedures.

Conclusions:

  • Oral care clinicians require a strong understanding of NOACs, including edoxaban's mechanism, pharmacology, and bleeding management.
  • Further clinical studies are needed to develop evidence-based guidelines for dental patients on edoxaban.
  • Increased use of NOACs necessitates updated clinical protocols in dentistry.