Anticoagulation Use prior to Common Dental Procedures: A Systematic Review
Currently, the number of patients on oral anticoagulation is increasing. There is a paucity of data regarding maintaining oral anticoagulation (especially novel oral anticoagulants) around the time of specific dental procedures. A dentist has three options: either to stop anticoagulation, to continu...
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| Format: | Article |
| Language: | English |
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Wiley
2019-01-01
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| Series: | Cardiology Research and Practice |
| Online Access: | http://dx.doi.org/10.1155/2019/9308631 |
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| _version_ | 1849396065343635456 |
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| author | Johnny Chahine Marwan N. Khoudary Samer Nasr |
| author_facet | Johnny Chahine Marwan N. Khoudary Samer Nasr |
| author_sort | Johnny Chahine |
| collection | DOAJ |
| description | Currently, the number of patients on oral anticoagulation is increasing. There is a paucity of data regarding maintaining oral anticoagulation (especially novel oral anticoagulants) around the time of specific dental procedures. A dentist has three options: either to stop anticoagulation, to continue it, or to bridge with heparin. A systematic review of 10 clinical trials was conducted to address this issue. It was found that continuing anticoagulation during dental procedures did not increase the risk of bleeding in most trials. Although none of the studies reported a thromboembolic event after interruption of anticoagulation, the follow-up periods were short and inconsistent, and the heightened thromboembolic risk when stopping anticoagulation is well known in the literature. Heparin bridging was associated with an increased bleeding incidence. We recommend maintaining oral anticoagulation with vitamin K antagonists and novel oral anticoagulants for the vast majority of dental procedures along with the use of local hemostatic agents. |
| format | Article |
| id | doaj-art-b56bbab9614c48049c8e36ded0a7168e |
| institution | Kabale University |
| issn | 2090-8016 2090-0597 |
| language | English |
| publishDate | 2019-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Cardiology Research and Practice |
| spelling | doaj-art-b56bbab9614c48049c8e36ded0a7168e2025-08-20T03:39:26ZengWileyCardiology Research and Practice2090-80162090-05972019-01-01201910.1155/2019/93086319308631Anticoagulation Use prior to Common Dental Procedures: A Systematic ReviewJohnny Chahine0Marwan N. Khoudary1Samer Nasr2Department of Internal Medicine, Cleveland Clinic Foundation Fairview Hospital, Cleveland, OH, USADepartment of Conventional and Surgical Endodontics, Senior Instructor, St Joseph University, Beirut, LebanonHead of Department of Electrophysiology and Cardiology, Mount Lebanon Hospital, Lebanese University, Beirut, LebanonCurrently, the number of patients on oral anticoagulation is increasing. There is a paucity of data regarding maintaining oral anticoagulation (especially novel oral anticoagulants) around the time of specific dental procedures. A dentist has three options: either to stop anticoagulation, to continue it, or to bridge with heparin. A systematic review of 10 clinical trials was conducted to address this issue. It was found that continuing anticoagulation during dental procedures did not increase the risk of bleeding in most trials. Although none of the studies reported a thromboembolic event after interruption of anticoagulation, the follow-up periods were short and inconsistent, and the heightened thromboembolic risk when stopping anticoagulation is well known in the literature. Heparin bridging was associated with an increased bleeding incidence. We recommend maintaining oral anticoagulation with vitamin K antagonists and novel oral anticoagulants for the vast majority of dental procedures along with the use of local hemostatic agents.http://dx.doi.org/10.1155/2019/9308631 |
| spellingShingle | Johnny Chahine Marwan N. Khoudary Samer Nasr Anticoagulation Use prior to Common Dental Procedures: A Systematic Review Cardiology Research and Practice |
| title | Anticoagulation Use prior to Common Dental Procedures: A Systematic Review |
| title_full | Anticoagulation Use prior to Common Dental Procedures: A Systematic Review |
| title_fullStr | Anticoagulation Use prior to Common Dental Procedures: A Systematic Review |
| title_full_unstemmed | Anticoagulation Use prior to Common Dental Procedures: A Systematic Review |
| title_short | Anticoagulation Use prior to Common Dental Procedures: A Systematic Review |
| title_sort | anticoagulation use prior to common dental procedures a systematic review |
| url | http://dx.doi.org/10.1155/2019/9308631 |
| work_keys_str_mv | AT johnnychahine anticoagulationusepriortocommondentalproceduresasystematicreview AT marwannkhoudary anticoagulationusepriortocommondentalproceduresasystematicreview AT samernasr anticoagulationusepriortocommondentalproceduresasystematicreview |