Anticoagulation Use prior to Common Dental Procedures: A Systematic Review

Area of Science:

• Medical Science
• Dental Surgery
• Pharmacology

Background:

• Increasing use of oral anticoagulation, including novel oral anticoagulants (NOACs).
• Limited data on managing anticoagulation during dental procedures.
• Dentists face decisions: stop, continue, or bridge anticoagulation.

Purpose of the Study:

• To systematically review evidence on managing oral anticoagulation during dental procedures.
• To assess bleeding and thromboembolic risks associated with different anticoagulation management strategies.

Main Methods:

• Systematic review of 10 clinical trials.
• Analysis of data on bleeding and thromboembolic events.

Main Results:

• Continuing anticoagulation did not significantly increase bleeding risk in most trials.
• Heparin bridging was associated with higher bleeding incidence.
• No reported thromboembolic events after interruption, but follow-up was limited.

Conclusions:

• Maintain oral anticoagulation (warfarin and NOACs) for most dental procedures.
• Utilize local hemostatic agents to manage bleeding risk.
• Stopping anticoagulation carries known thromboembolic risks.