Management of dental patients taking anticoagulants or antiplatelet drugs

An increasing number of patients are being prescribed anticoagulants or antiplatelet drugs for prevention of stroke or thrombo-embolic events.

Essentially the drugs are divided into two main groups

Anticoagulants

  • Warfarin (& other vitamin K antagonists)
  • Novel or new oral anticoagulants - NOACs (e.g. dabigatran, rivaroxaban & apixaban)

Antiplatelets

  • Aspirin, clopidogrel & prasugrel

The advice as how to best manage these patients (especially those on Novel oral anticoagulants) is still evolving and depends on the drug that is being taken, any co-morbidities / medicines and the treatment proposed. Strong evidence is lacking and is currently based around expert opinion, consensus and existing guidance / experience.

The OMFS department does NOT have a local guideline / policy regarding this but the interested reader is directed to the following national guidance & articles.

Scottish Dental Clinical Effectiveness Programme - "Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs" - published August 2015

NICE Clinical Knowledge Summary

http://cks.nice.org.uk/anticoagulation-oral#!management

Curtin C, Hayes JM, Hayes SJ. Dental implications of new oral anticoagulants for atrial fibrillation. Dental Update. 2014;41:526-531

 

Page updated 09/02/16