Table 3 Medical consultation suggestions for the management of patients using blood thinners prior to dental interventions. INR, international normalized ratio; DOAC, direct acting oral anticoagulants; LMWH, low molecular weight heparin
From: Attitude and practice of dentists in patients taking oral antiplatelet and anticoagulant medications
Drug | Answer | % |
|---|---|---|
Antiplatelet agents (#10) | Discontinue 5–7 days preoperatively | 58.2 |
Continue actual therapy | 8.8 | |
Discontinue and bridge with LMWH | 21.9 | |
Decision left to dentist based on hemorrhagic and thromboembolic risks | 6.3 | |
No idea | 4.8 | |
Warfarin (#15) | Discontinue 5–7 days preoperatively | 16.8 |
Continue warfarin if bleeding risk and INR level is within desired range | 25.7 | |
Discontinue and bridge it with LMWH | 46.3 | |
Decision left to dentist based on hemorrhagic and thromboembolic risks | 1.1 | |
No idea | 10 | |
DOACs (#17) | Continue DOAC if bleeding risk is not high | 10.1 |
Continue DOAC regardless of bleeding risk | 15.6 | |
Discontinue DOAC | 16.4 | |
Just skip the last dose of DOAC | 6.2 | |
Discontinue DOAC and replace it with aspirin | 1.6 | |
Discontiue DOAC and bridge with LMWH | 12.5 | |
Decision made based on INR level of the patient | 16.6 | |
No idea | 21 |