[Using the new clinical guidelines on antithrombotics in the dental practice]

A 64-year-old man has deep caries in tooth 37 without acute pain; extraction is indicated, however. According to his list of medications, he takes the antithrombotics apixaban and clopidogrel. Or: a 78-year-old woman has upper and lower dentures that don't function well, and she experiences retention problems. Implant-bearing upper and lower dentures on 4 and 2 implants, respectively, are indicated. The patient takes acenocoumarol and reports that the clotting time value of her blood (INR) sometimes fluctuates. The clinical guidelines 'Dental procedures in patients using antithrombotic medication', which recently appeared, offer oral healthcare providers recommendations for reducing the risk of bleeding while observing the risk of thrombosis. These guidelines by the Dutch Institute of Expertise for Oral Healthcare replace the previous guidelines from 2012. The recommendations are up to date with current practice in the Netherlands and take into account all antithrombotics patients may currently use in an outpatient setting. Furthermore, the responsibilities of the oral healthcare providers and the agreements with thrombosis services are formalised in these guidelines.