Awareness and Perception of Dentists in Kuwait Regarding the Dental Management of Patients on Oral Antithrombotic Medications

Abstract

Objective It is crucial that dentists are up to date on the most recent recommendations for managing patients on oral antithrombotic medications (OAMs). The current study aims to analyze dental practitioners' knowledge and practice of perioperative treatment of patients on OAM in Kuwait. Materials and Methods The study was performed among dentists in Kuwait utilizing a structured questionnaire. The questionnaire tested their knowledge about common OAMs and their indications, the bleeding risk of specific dental procedures, as well as the dangers of stopping antithrombotic therapy. Questions regarding the practice of obtaining relevant blood investigations as well as consultations with health professionals and their current course of management pertaining to specific dental procedures were included. Statistical Analysis The collected data were analyzed by SPSS statistical software for Windows, version 28.0 (Chicago, Illinois, United States). The Student's t-test was used to compare mean percentage knowledge scores. Association between independent variables (predictors) and knowledge was assessed by employing univariate and multivariate logistic regression. A p-value of ≤ 0.05 was considered statistically significant. Results A majority of the dentists (60.9%) demonstrated fair knowledge. Gender, practice type, and years of experience were significantly associated with knowledge. Very few dentists knew about direct oral anticoagulants. Eighty-two (33.1%) would rely on international normalized ratio tests done within 72 hours. Sixty-six (26.6%) dentists would interrupt aspirin therapy before extensive dental scaling without a medical consult and 45 (18.1%) would ask the patient to stop warfarin 3 days before extraction of one to three teeth. For patients on aspirin or warfarin, 35.1 and 47.2% of the dentists perceived the postoperative bleeding risk after a simple extraction to be high, and 14.4 and 11.2% of the dentists considered the rethrombosis risk to be low if aspirin and warfarin were interrupted. Conclusion In this study, the dentists demonstrate a lack of knowledge and are not clear regarding practice recommendations. Every dental care provider therefore needs to update their knowledge with the latest antithrombotic medications and their indications, when to order blood investigations and medical consult, bleeding risk associated with each dental procedure, interruption of therapy, and risk of bleeding versus rethrombosis risk.