Post-extraction bleeding in patients on direct oral anticoagulants
Min-Ji Kim1, Moon-Key Kim2, Sang-Hoon Kang2
1Department of Oral and Maxillofacial Surgery, Yonsei University College of Dentistry, Seoul, Korea.
Summary
Continuing direct oral anticoagulants (DOACs) during dental extraction does not increase post-extraction bleeding risk. This finding supports safe management of patients on DOACs undergoing tooth removal.
Area of Science:
- Oral and Maxillofacial Surgery
- Cardiology
- Pharmacology
Background:
- Direct oral anticoagulants (DOACs) are widely prescribed for thromboprophylaxis.
- Managing patients on DOACs requiring dental procedures necessitates understanding bleeding risks.
Purpose of the Study:
- To evaluate the association between continuing direct oral anticoagulants (DOACs) and post-extraction bleeding.
- To quantify the bleeding risk in patients undergoing tooth extraction while on DOAC therapy.
Main Methods:
- A study involving 293 patients undergoing 414 tooth extractions.
- Patients were categorized into two groups: those continuing DOACs and those who discontinued DOACs prior to extraction.
- Bleeding complications were recorded and compared between groups.
Main Results:
- Post-extraction bleeding occurred in 6.9% of patients (12 out of 293).
- 12 patients (8.5%) who continued DOACs experienced bleeding, compared to none in the group that discontinued DOACs.
- No statistically significant difference in bleeding complications was observed between the groups (P=0.122).
Conclusions:
- Continuing DOAC therapy during dental extraction is not associated with an increased tendency for post-extraction bleeding.
- The findings align with previous research, suggesting current DOACs can be safely managed during dental procedures.
Related Concept Videos
01:18Anticoagulant Drugs: Vitamin K Antagonists and Direct Oral Anticoagulants
1.2K
Oral anticoagulants are vital tools in preventing and treating blood clotting disorders. This diverse class of medications can be categorized as vitamin K antagonists, exemplified by warfarin, and direct thrombin inhibitors (DTIs), such as dabigatran, as well as factor Xa inhibitors, including rivaroxaban.
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
Warfarin, a prominent vitamin K antagonist family member, exerts its effect by inhibiting the enzyme VKORC1 (vitamin K epoxide reductase complex 1). By hindering this enzyme, warfarin...
1.2K
01:30Anticoagulant Drugs: Low-Molecular-Weight Heparins
654
Hemostasis is a crucial process that prevents excessive blood loss from damaged blood vessels. It involves various mechanisms such as vasoconstriction, platelet adhesion and activation, and fibrin formation. The importance of each mechanism depends on the type of vessel injury. In contrast, thrombosis is the abnormal formation of a blood clot within the blood vessels, leading to potential complications if the clot obstructs blood flow. Thrombosis can be caused by increased coagulability of the...
654
01:24Disorders of Hemostasis
754
Hemostasis, the process that stops bleeding after a blood vessel injury, is crucial for maintaining the integrity of the circulatory system. However, disorders of hemostasis can disrupt this delicate balance, leading to either excessive clotting or bleeding. These disorders can be broadly classified into thromboembolic disorders and bleeding disorders.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
Thromboembolic Disorders
Two factors primarily cause thromboembolic conditions.
754
01:20Extrinsic and Intrinsic Pathways of Hemostasis
6.5K
Blood clotting or coagulation involves extrinsic and intrinsic pathways, which ultimately merge into the common pathway, forming a fibrin clot.
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
The Extrinsic Pathway
The extrinsic pathway of coagulation is typically initiated by tissue damage that exposes blood to tissue factor (TF), a protein released by the damaged tissue cells outside the blood vessels—this interaction with TF triggers biochemical reactions involving specific clotting factors. The key player here is Factor VII, which...
6.5K
01:20Antiplatelet Drugs: Prostaglandin Synthesis, P2Y12 and Glycoprotein IIb/IIIa Inhibitors
499
Antiplatelet drugs emerge as frontline defenders against the insidious threat of thromboembolic diseases, where abnormal clots obstruct vital blood vessels. These drugs stand as bulwarks, inhibiting platelet aggregation and clot formation, thereby mitigating the risk of life-threatening conditions like myocardial infarction, coronary artery disease, and thrombotic strokes.
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
Prostaglandin synthesis inhibitors, exemplified by the widely known aspirin, wield their power by irreversibly acetylating...
499
01:05Introduction to Hemostasis
6.7K
Hemostasis is a complex physiological process that prevents excessive bleeding when a blood vessel is injured. It's crucial for maintaining the integrity of the circulatory system, as it ensures that our blood remains fluid while still within the vascular network and yet clots to prevent blood loss upon vessel injury.
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
The three phases of hemostasis involve many clotting factors present in plasma and several substances released by platelets and injured tissue cells. It is a fast, localized,...
6.7K