The dental patient on oral anticoagulant medication: A literature review

Journal of Oral Rehabilitation

Volumn 38, Issue 8, 2011, Pages 615-633

  Kosyfaki, P ^a   Att, W ^a   Strub, J R ^a  

^a UNIVERSITY OF FREIBURG   (Germany)

Author keywords

Bleeding risk; Dental treatment; Oral anticoagulants; Oral surgery; Thromboembolic risk; Warfarin

Indexed keywords

ANTICOAGULANT AGENT;

CARDIOVASCULAR DISEASE; DENTAL CARE; HUMAN; METHODOLOGY; ORAL SURGERY; POSTOPERATIVE HEMORRHAGE; REVIEW;

ANTICOAGULANTS; CARDIOVASCULAR DISEASES; DENTAL CARE FOR CHRONICALLY ILL; HUMANS; ORAL SURGICAL PROCEDURES; POSTOPERATIVE HEMORRHAGE;

EID: 79960146031     PISSN: 0305182X     EISSN: 13652842     Source Type: Journal    
DOI: 10.1111/j.1365-2842.2010.02184.x     Document Type: Review

References (110)

1. Scully C, Ettinger RL. The influence of systemic diseases on oral health care in older adults. J Am Dent Assoc. 2007;138(Suppl):7S-14S.
2. Scully C, Hobkirk J, Dios PD. Dental endosseous implants in the medically compromised patient. J Oral Rehabil. 2007;34:590-599.
3. Sugerman PB, Barber MT. Patient selection for endosseous dental implants: oral and systemic considerations. Int J Oral Maxillofac Implants. 2002;17:191-201.
4. Bornstein MM, Cionca N, Mombelli A. Systemic conditions and treatments as risks for implant therapy. Int J Oral Maxillofac Implants. 2009;24(Suppl):12-27.
5. Key NS, Kasthuri RS. Current treatment of venous thromboembolism. Arterioscler Thromb Vasc Biol. 2010;30:372-375.
6. Osinbowale O, Ali L, Chi YW. Venous thromboembolism: a clinical review. Postgrad Med. 2010;122:54-65.
7. Tran H, McRae S, Ginsberg J. Anticoagulant treatment of deep vein thrombosis and pulmonary embolism. Cardiol Clin. 2008;26:235-250. vi-vii.
8. Mackman N. Triggers, targets and treatments for thrombosis. Nature. 2008;451:914-918.
9. Singer DE, Albers GW, Dalen JE, Fang MC, Go AS, Halperin JL et al. Antithrombotic therapy in atrial fibrillation: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:546S-592S.
10. Crandall MA, Bradley DJ, Packer DL, Asirvatham SJ. Contemporary management of atrial fibrillation: update on anticoagulation and invasive management strategies. Mayo Clin Proc. 2009;84:643-662.
11. Salem DN, Stein PD, Al-Ahmad A, Bussey HI, Horstkotte D, Miller N et al. Antithrombotic therapy in valvular heart disease - native and prosthetic: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:457S-482S.
12. Ansell J, Hirsh J, Poller L, Bussey H, Jacobson A, Hylek E. The pharmacology and management of the vitamin K antagonists: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest. 2004;126:204S-233S.
13. Friedlander AH, Yoshikawa TT, Chang DS, Feliciano Z, Scully C. Atrial fibrillation: pathogenesis, medical-surgical management and dental implications. J Am Dent Assoc. 2009;140:167-177. quiz 248.
14. Heit JA. Perioperative management of the chronically anticoagulated patient. J Thromb Thrombolysis. 2001;12:81-87.
15. Lockhart PB, Gibson J, Pond SH, Leitch J. Dental management considerations for the patient with an acquired coagulopathy. Part 2: coagulopathies from drugs. Br Dent J. 2003;195:495-501.
16. Hirsh J, Fuster V, Ansell J, Halperin JL. American Heart Association/American College of Cardiology Foundation guide to warfarin therapy. Circulation. 2003;107:1692-1711.
17. Othieno R, Abu Affan M, Okpo E. Home versus in-patient treatment for deep vein thrombosis. Cochrane Database Syst Rev. 2007:CD003076.
18. Robert-Ebadi H, Le Gal G, Righini M. Use of anticoagulants in elderly patients: practical recommendations. Clin Interv Aging. 2009;4:165-177.
19. Jeske AH, Suchko GD. Lack of a scientific basis for routine discontinuation of oral anticoagulation therapy before dental treatment. J Am Dent Assoc. 2003;134:1492-1497.
20. Wahl MJ. Myths of dental surgery in patients receiving anticoagulant therapy. J Am Dent Assoc. 2000;131:77-81.
21. Chugani V. Management of dental patients on warfarin therapy in a primary care setting. Dent Update. 2004;31:379-382, 84.
22. Herman WW, Konzelman JL Jr, Sutley SH. Current perspectives on dental patients receiving coumarin anticoagulant therapy. J Am Dent Assoc. 1997;128:327-335.
23. Hirsh J, Dalen J, Anderson DR, Poller L, Bussey H, Ansell J et al. Oral anticoagulants: mechanism of action, clinical effectiveness, and optimal therapeutic range. Chest. 2001;119:8S-21S.
24. Baglin TP, Cousins D, Keeling DM, Perry DJ, Watson HG. Safety indicators for inpatient and outpatient oral anticoagulant care: [corrected] Recommendations from the British Committee for Standards in Haematology and National Patient Safety Agency. Br J Haematol. 2007;136:26-29.
25. Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165:1095-1106.
26. Jiménez Y, Poveda R, Gavaldá C, Margaix M, Sarrión G. An update on the management of anticoagulated patients programmed for dental extractions and surgery. Med Oral Patol Oral Cir Bucal. 2008;13:E176-E179.
27. Ward BB, Smith MH. Dentoalveolar procedures for the anticoagulated patient: literature recommendations versus current practice. J Oral Maxillofac Surg. 2007;65:1454-1460.
28. Sindet-Pedersen S, Ramström G, Bernvil S, Blömback M. Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. N Engl J Med. 1989;320:840-843.
29. Borea G, Montebugnoli L, Capuzzi P, Magelli C. Tranexamic acid as a mouthwash in anticoagulant-treated patients undergoing oral surgery. An alternative method to discontinuing anticoagulant therapy. Oral Surg Oral Med Oral Pathol. 1993;75:29-31.
30. Ramström G, Sindet-Pedersen S, Hall G, Blömback M, Alander U. Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants. J Oral Maxillofac Surg. 1993;51:1211-1216.
31. Souto JC, Oliver A, Zuazu-Jausoro I, Vives A, Fontcuberta J. Oral surgery in anticoagulated patients without reducing the dose of oral anticoagulant: a prospective randomized study. J Oral Maxillofac Surg. 1996;54:27-32. discussion 323.
32. Evans IL, Sayers MS, Gibbons AJ, Price G, Snooks H, Sugar AW. Can warfarin be continued during dental extraction? Results of a randomized controlled trial Br J Oral Maxillofac Surg. 2002;40:248-252.
33. Halfpenny W, Fraser JS, Adlam DM. Comparison of 2 hemostatic agents for the prevention of postextraction hemorrhage in patients on anticoagulants. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2001;92:257-259.
34. Al-Belasy FA, Amer MZ. Hemostatic effect of n-butyl-2-cyanoacrylate (histoacryl) glue in warfarin-treated patients undergoing oral surgery. J Oral Maxillofac Surg. 2003;61:1405-1409.
35. Carter G, Goss A. Tranexamic acid mouthwash--a prospective randomized study of a 2-day regimen vs 5-day regimen to prevent postoperative bleeding in anticoagulated patients requiring dental extractions. Int J Oral Maxillofac Surg. 2003;32:504-507.
36. Carter G, Goss A, Lloyd J, Tocchetti R. Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: a randomized prospective clinical study. J Oral Maxillofac Surg. 2003;61:1432-1435.
37. Al-Mubarak S, Al-Ali N, Abou-Rass M, Al-Sohail A, Robert A, Al-Zoman K et al. Evaluation of dental extractions, suturing and INR on postoperative bleeding of patients maintained on oral anticoagulant therapy. Br Dent J. 2007;203:E15. discussion 410-1.
38. Al-Mubarak S, Rass MA, Alsuwyed A, Alabdulaaly A, Ciancio S. Thromboembolic risk and bleeding in patients maintaining or stopping oral anticoagulant therapy during dental extraction. J Thromb Haemost. 2006;4:689-691.
39. Bajkin BV, Popovic SL, Selakovic SD. Randomized, prospective trial comparing bridging therapy using low-molecular-weight heparin with maintenance of oral anticoagulation during extraction of teeth. J Oral Maxillofac Surg. 2009;67:990-995.
40. Malmquist JP, Clemens SC, Oien HJ, Wilson SL. Hemostasis of oral surgery wounds with the HemCon Dental Dressing. J Oral Maxillofac Surg. 2008;66:1177-1183.
41. Sacco R, Sacco M, Carpenedo M, Mannucci PM. Oral surgery in patients on oral anticoagulant therapy: a randomized comparison of different intensity targets. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;104:e18-e21.
42. Sacco R, Sacco M, Carpenedo M, Moia M. Oral surgery in patients on oral anticoagulant therapy: a randomized comparison of different INR targets. J Thromb Haemost. 2006;4:688-689.
43. Blinder D, Manor Y, Martinowitz U, Taicher S. Dental extractions in patients maintained on oral anticoagulant therapy: comparison of INR value with occurrence of postoperative bleeding. Int J Oral Maxillofac Surg. 2001;30:518-521.
44. Blinder D, Manor Y, Martinowitz U, Taicher S, Hashomer T. Dental extractions in patients maintained on continued oral anticoagulant: comparison of local hemostatic modalities. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1999;88:137-140.
45. Campbell JH, Alvarado F, Murray RA. Anticoagulation and minor oral surgery: should the anticoagulation regimen be altered? J Oral Maxillofac Surg. 2000;58:131-135. discussion 5-6.
46. Gaspar R, Brenner B, Ardekian L, Peled M, Laufer D. Use of tranexamic acid mouthwash to prevent postoperative bleeding in oral surgery patients on oral anticoagulant medication. Quintessence Int. 1997;28:375-379.
47. Mehra P, Cottrell DA, Bestgen SC, Booth DF. Management of heparin therapy in the high-risk, chronically anticoagulated, oral surgery patient: a review and a proposed nomogram. J Oral Maxillofac Surg. 2000;58:198-202.
48. Bailey BM, Fordyce AM. Complications of dental extractions in patients receiving warfarin anticoagulant therapy. A controlled clinical trial. Br Dent J. 1983;155:308-310.
49. Cannon PD, Dharmar VT. Minor oral surgical procedures in patients on oral anticoagulants--a controlled study. Aust Dent J. 2003;48:115-118.
50. Devani P, Lavery KM, Howell CJ. Dental extractions in patients on warfarin: is alteration of anticoagulant regime necessary? Br J Oral Maxillofac Surg. 1998;36:107-111.
51. Dunn AS, Spyropoulos AC, Turpie AG. Bridging therapy in patients on long-term oral anticoagulants who require surgery: the Prospective Peri-operative Enoxaparin Cohort Trial (PROSPECT). J Thromb Haemost. 2007;5:2211-2218.
52. Morimoto Y, Niwa H, Minematsu K. Hemostatic management of tooth extractions in patients on oral antithrombotic therapy. J Oral Maxillofac Surg. 2008;66:51-57.
53. Spyropoulos AC, Turpie AG, Dunn AS, Spandorfer J, Douketis J, Jacobson A et al. Clinical outcomes with unfractionated heparin or low-molecular-weight heparin as bridging therapy in patients on long-term oral anticoagulants: the REGIMEN registry. J Thromb Haemost. 2006;4:1246-1252.
54. Bodner L, Weinstein JM, Baumgarten AK. Efficacy of fibrin sealant in patients on various levels of oral anticoagulant undergoing oral surgery. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 1998;86:421-424.
55. Ferrieri GB, Castiglioni S, Carmagnola D, Cargnel M, Strohmenger L, Abati S. Oral surgery in patients on anticoagulant treatment without therapy interruption. J Oral Maxillofac Surg. 2007;65:1149-1154.
56. Martinowitz U, Mazar AL, Taicher S, Varon D, Gitel SN, Ramot B et al. Dental extraction for patients on oral anticoagulant therapy. Oral Surg Oral Med Oral Pathol. 1990;70:274-277.
57. Salam S, Yusuf H, Milosevic A. Bleeding after dental extractions in patients taking warfarin. Br J Oral Maxillofac Surg. 2007;45:463-466.
58. Garcia DA, Regan S, Henault LE, Upadhyay A, Baker J, Othman M et al. Risk of thromboembolism with short-term interruption of warfarin therapy. Arch Intern Med. 2008;168:63-69.
59. Zanon E, Martinelli F, Bacci C, Cordioli G, Girolami A. Safety of dental extraction among consecutive patients on oral anticoagulant treatment managed using a specific dental management protocol. Blood Coagul Fibrinolysis. 2003;14:27-30.
60. Johnson-Leong C, Rada RE. The use of low-molecular-weight heparins in outpatient oral surgery for patients receiving anticoagulation therapy. J Am Dent Assoc. 2002;133:1083-1087.
61. Todd DW, Roman A. Outpatient use of low-molecular weight heparin in an anticoagulated patient requiring oral surgery: case report. J Oral Maxillofac Surg. 2001;59:1090-1092. discussion 2-3.
62. Bloomer CR. Excessive hemorrhage after dental extractions using low-molecular-weight heparin (Lovenox) anticoagulation therapy. J Oral Maxillofac Surg. 2004;62:101-103.
63. Della Valle A, Sammartino G, Marenzi G, Tia M, Espedito di Lauro A, Ferrari F et al. Prevention of postoperative bleeding in anticoagulated patients undergoing oral surgery: use of platelet-rich plasma gel. J Oral Maxillofac Surg. 2003;61:1275-1278.
64. Ramli R, Abdul Rahman R. Minor oral surgery in anticoagulated patients: local measures alone are sufficient for haemostasis. Singapore Dent J. 2005;27:13-16.
65. Russo G, Corso LD, Biasiolo A, Berengo M, Pengo V. Simple and safe method to prepare patients with prosthetic heart valves for surgical dental procedures. Clin Appl Thromb Hemost. 2000;6:90-93.
66. Zusman SP, Lustig JP, Baston I. Postextraction hemostasis in patients on anticoagulant therapy: the use of a fibrin sealant. Quintessence Int. 1992;23:713-716.
67. Hong CH, Napenas JJ, Brennan MT, Furney SL, Lockhart PB. Frequency of bleeding following invasive dental procedures in patients on low-molecular-weight heparin therapy. J Oral Maxillofac Surg. 2010;68:975-979.
68. Wahl MJ, Howell J Altering anticoagulation therapy: a survey of physicians. J Am Dent Assoc. 1996;127:625-626, 9-30, 33-4 passim.
69. Wahl MJ. Dental surgery in anticoagulated patients. Arch Intern Med. 1998;158:1610-1616.
70. Seymour RA, Preshaw PM, Thomason JM, Ellis JS, Steele JG. Cardiovascular diseases and periodontology. J Clin Periodontol. 2003;30:279-292.
71. Beirne OR. Evidence to continue oral anticoagulant therapy for ambulatory oral surgery. J Oral Maxillofac Surg. 2005;63:540-545.
72. Dunn AS, Turpie AG. Perioperative management of patients receiving oral anticoagulants: a systematic review. Arch Intern Med. 2003;163:901-908.
73. Madrid C, Sanz M. What influence do anticoagulants have on oral implant therapy? A systematic review Clin Oral Implants Res. 2009;4:96-106.
74. Nematullah A, Alabousi A, Blanas N, Douketis JD, Sutherland SE. Dental surgery for patients on anticoagulant therapy with warfarin: a systematic review and meta-analysis. J Can Dent Assoc. 2009;75:41.
75. Scully C, Wolff A. Oral surgery in patients on anticoagulant therapy. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;94:57-64.
76. Todd DW. Evidence to support an individualized approach to modification of oral anticoagulant therapy for ambulatory oral surgery. J Oral Maxillofac Surg. 2005;63:536-539.
77. Antonio N, Castro G, Ramos D, Machado A, Goncalves L, Macedo T et al. The debate concerning oral anticoagulation: whether to suspend oral anticoagulants during dental treatment. Rev Port Cardiol. 2008;27:531-544.
78. Beirne OR, Koehler JR. Surgical management of patients on warfarin sodium. J Oral Maxillofac Surg. 1996;54:1115-1118.
79. Carter G, Goss AN, Lloyd J, Tocchetti R. Current concepts of the management of dental extractions for patients taking warfarin. Aust Dent J. 2003;48:89-96. quiz 138.
80. Perry DJ, Noakes TJ, Helliwell PS. Guidelines for the management of patients on oral anticoagulants requiring dental surgery. Br Dent J. 2007;203:389-393.
81. Randall C. Surgical management of the primary care dental patient on warfarin. Dent Update. 2005;32:414-416, 9-20, 23-4 passim.
82. Aframian DJ, Lalla RV, Peterson DE. Management of dental patients taking common hemostasis-altering medications. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007;103(Suppl):S45 e1-11.
83. Douketis JD, Berger PB, Dunn AS, Jaffer AK, Spyropoulos AC, Becker RC et al. The perioperative management of antithrombotic therapy: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest. 2008;133:299S-339S.
84. Carr MM, Mason RB. Dental management of anticoagulated patients. J Can Dent Assoc. 1992;58:838-844.
85. Patatanian E, Fugate SE. Hemostatic mouthwashes in anticoagulated patients undergoing dental extraction. Ann Pharmacother. 2006;40:2205-2210.
86. Pototski M, Amenabar JM. Dental management of patients receiving anticoagulation or antiplatelet treatment. J Oral Sci. 2007;49:253-258.
87. Weibert RT. Oral anticoagulant therapy in patients undergoing dental surgery. Clin Pharm. 1992;11:857-864.
88. Dunn CJ, Goa KL. Fibrin sealant: a review of its use in surgery and endoscopy. Drugs 1999;58:863-886.
89. Mulligan R, Weitzel KG. Pretreatment management of the patient receiving anticoagulant drugs. J Am Dent Assoc. 1988;117:479-483.
90. Roser SM, Rosenbloom B. Continued anticoagulation in oral surgery procedures. Oral Surg Oral Med Oral Pathol. 1975;40:448-457.
91. Dewan K, Bishop K, Muthukrishnan A. Management of patients on warfarin by general dental practitioners in South West Wales: continuing the audit cycle. Br Dent J. 2009;206:E8. discussion 214-5.
92. McKittrick T, Hutchinson R, Twitchell J. Temporary discontinuation of warfarin therapy: changes in the international normalized ration. Ann Intern Med. 1995;122:40-42.
93. Bailey BM, Fordyce AM. Warfarin anticoagulant therapy. Br Dent J. 1984;156:310.
94. du Breuil AL, Umland EM. Outpatient management of anticoagulation therapy. Am Fam Physician. 2007;75:1031-1042.
95. Schardt-Sacco D. Update on coagulopathies. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2000;90:559-563.
96. Martel N, Lee J, Wells PS. Risk for heparin-induced thrombocytopenia with unfractionated and low-molecular-weight heparin thromboprophylaxis: a meta-analysis. Blood 2005;106:2710-2715.
97. Hirsh J, Fuster V. Guide to anticoagulant therapy. Part 2: oral anticoagulants. American Heart Association. Circulation 1994;89:1469-1480.
98. Baker RI, Coughlin PB, Gallus AS, Harper PL, Salem HH, Wood EM. Warfarin reversal: consensus guidelines, on behalf of the Australasian Society of Thrombosis and Haemostasis. Med J Aust. 2004;181:492-497.
99. Ball JH. Management of the anticoagulated dental patient. Compend Contin Educ Dent. 1996;17:1100-1102, 4, 6 passim.
100. Little JW, Miller CS, Henry RG, McIntosh BA. Antithrombotic agents: implications in dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002;93:544-551.
101. Rice PJ, Perry RJ, Afzal Z, Stockley IH. Antibacterial prescribing and warfarin: a review. Br Dent J. 2003;194:411-415.
102. Fugh-Berman A, Ernst E. Herb-drug interactions: review and assessment of report reliability. Br J Clin Pharmacol. 2001;52:587-595.
103. Miller LG. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158:2200-2211.
104. Vanschoonbeek K, de Maat MP, Heemskerk JW. Fish oil consumption and reduction of arterial disease. J Nutr. 2003;133:657-660.
105. Harris WS. Expert opinion: omega-3 fatty acids and bleeding-cause for concern? Am J Cardiol. 2007;99:44C-46C.
106. Lee YH, Lee BK, Choi YJ, Yoon IK, Chang BC, Gwak HS. Interaction between warfarin and Korean red ginseng in patients with cardiac valve replacement. Int J Cardiol. 2009; In press. Doi: 10.1016/j.ijcard.2009.09.553.
107. Jiang X, Blair EY, McLachlan AJ. Investigation of the effects of herbal medicines on warfarin response in healthy subjects: a population pharmacokinetic-pharmacodynamic modeling approach. J Clin Pharmacol. 2006;46:1370-1378.
108. Eritsland J, Arnesen H, Seljeflot I, Kierulf P. Long-term effects of n-3 polyunsaturated fatty acids on haemostatic variables and bleeding episodes in patients with coronary artery disease. Blood Coagul Fibrinolysis. 1995;6:17-22.
109. Johnson WT, Leary JM. Management of dental patients with bleeding disorders: review and update. Oral Surg Oral Med Oral Pathol. 1988;66:297-303.
110. Patton LL, Ship JA. Treatment of patients with bleeding disorders. Dent Clin North Am. 1994;38:465-482.