We take a look at the recently updated guidance on the Management of Dental Patients Taking Anticoagulants or Antiplatelet Drug from the Scottish Dental Clinical effectiveness programme (SDCEP).
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This review of the evidence of bleeding events following invasive oral procedures in patients using direct anticoagulant agents (DOACs) identified 21 studies but no RCTs. The review found no important differences in bleeding events in patients who continued versus patients who discontinued DOAC therapy.
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This Cochrane review of antifibrinolytic agents for preventing bleeding in people on oral anticoagulants undergoing dental extractions or minor oral surgery included 4 RCTs. Topical tranexamic acid was effective in reducing post-operative bleeding following dental procedures.
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This review of the post oral surgery bleeding risk for patients on direct oral anticoagulants (DOACs) included 13 observational studies. The findings suggest a three-fold increase in bleeding for those patients on DOACs although the quality of the available evidence is limited.
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