Managing patients taking novel oral anticoagulants (NOAs) in dentistry: a discussion paper on clinical implications

BMC Oral Health
Fulvia CostantinidesMichele Maglione

Abstract

The aim of this paper is to contribute to the discussion on how to approach patients taking new orally administered anticoagulants (NOAs) dabigatran etexilate (a direct thrombin inhibitor), rivaroxaban and apixaban (factor Xa inhibitors), before, during and after dental treatment in light of the more recent knowledges. In dentistry and oral surgery, the major concerns in treatment of patients taking direct thrombin inhibitors and factor Xa inhibitors is the risk of haemorrhage and the absence of a specific reversal agent. The degree of renal function, the complexity of the surgical procedure and the patient's risk of bleeding due to other concomitant causes, are the most important factors to consider during surgical dental treatment of patients taking NOAs. For patients requiring simple dental extraction or minor oral surgery procedures, interruption of NOA is not generally necessary, while an higher control of bleeding and discontinuation of the drug (at least 24 h) should be requested before invasive surgical procedures, depending on renal functionality. The clinician has to consider that the number of patients taking NOAs is rapidly increasing. Since available data are not sufficient to establish an evidence-based dental man...Continue Reading

References

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Citations

Oct 22, 2016·Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology·Cédric MauprivezVianney Descroix
Jul 27, 2017·The European Journal of General Practice·Csaba András DézsiAndrás Döme Dézsi
Apr 22, 2017·British Dental Journal·S Nathwani, C Wanis
Sep 8, 2017·Journal of Dental Anesthesia and Pain Medicine·Chihun KimWonse Park
May 19, 2019·Oral and Maxillofacial Surgery·Carlos Fernando de Almeida Barros MourãoMônica Diuana Calasans-Maia
Jul 16, 2021·Journal of Endodontics·Anita AminoshariaeDale Baur

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