Current practices of Western Australian general dentists regarding management of patients on anticoagulant/antiplatelet therapy

Abstract

Purpose: Currently, there are little to no published studies outlining general dentists' knowledge in the management of patients on anticoagulant/antiplatelet therapies in Australia. The aim of this study was to investigate the current practices of Western Australian (WA) general dentists with regards to dental management of patients taking anticoagulants/antiplatelets. Materials and methods: WA dentists were invited to undertake a survey to investigate their knowledge on the management of patients taking anticoagulant/antiplatelet. The questionnaire provided to WA general dentists consisted of preextraction advice on patients (direct oral anticoagulants [DOACs], antiplatelets, warfarin, dual antiplatelets and antiplatelet/anticoagulant). Results were analysed using descriptive statistics as well as chi-square tests. Results: Of the 89 participants, 40.5% had <5 years of general dental experience. Most WA general dentists (64%-71%) responded with 'no change' when performing extractions on patients on DOACs, antiplatelet therapy, warfarin, dual antiplatelets and antiplatelets/anticoagulants (P = 0.00). Furthermore, dentists with 6-10 years of experience were more likely to cease antiplatelet for 24 h before extractions (P < 0.05). Dentists who extracted 10-30 teeth per month were likely to stop antiplatelets and DOACs for more than 48 h compared to other groups (P < 0.05). Conclusion: Most WA dentists would not cease anticoagulant/antiplatelet therapy when undergoing dental extractions.

Minor oral surgery under anticoagulant therapy: A review of the literature

“…Following minor oral surgery such as tooth extractions, the risk of postoperative bleeding is slightly lower in patients receiving DOAC without interruption of DOAC administration both preoperatively and postoperatively compared to patients receiving VKA, therefore, it is NOT necessary to adjust the dose of DOAC prior to tooth extractions. (27,28) Discontinue DOACs one day before or one day after surgical treatment.…”