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Abstract
Oral anticoagulants are medications prescribed to prevent clot formation and reduce the risk of thromboembolic events, such as strokes and deep vein thromboses. Currently, warfarin is the most used medication. Patients using these medications, who require oral surgeries such as tooth extractions, periodontal surgeries and implants, require specific care to minimize the risk of bleeding from the dental surgeon. Based on research of articles in Portuguese and English, published in the last 15 years in the PubMed and Scielo databases, the protocols for managing these patients by dental professionals were reviewed with a focus on the safety for the patient and the professional. With the increased risk of bleeding complications during and after dental procedures, the dental surgeon needs to be trained to care for this patients. Currently, the international normalized ratio (INR) is the main global test for monitoring and planning pre-surgical interventions, being performed 24 hours before the dental procedure. According to the World Health Organization, it is safe to perform surgical dental procedures with INR values between 2 and 3.5. In cases where the value exceeds 5, it is not advisable to carry out procedures, requiring referral to a doctor. A thorough assessment, including a detailed clinical interview and an accurate clinical and physical examination is essential. It is important to detect signs of hematological conditions, such as purpura, deep bruises, visible bruises, joint swelling and spontaneous nose and gum bleeding, because an early diagnosis leads to a more effective treatment. Dose adjustments or medication removal are considered in specific cases, but the measures are taken by the responsible physician. Dose adjustments or interruption of oral anticoagulant before less invasive dental procedures present risks of thromboembolic complications that exceed the risks of bleeding events. Exchanging information with the doctor is essential in making decisions for the management of anticoagulants.
References
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Copyright (c) 2024 giovanna de paula garcia, Amanda Raquel de Oliveira , Arthur Leonel Oliveira, Daniella Cristina Borges , Heitor Menezes Dias , Leonardo Bíscaro Pereira, Lorene Queiros Casali Reis, Marcos Bilharinho de Mendonça, Rodrigo Soares de Andrade , Ivania Aparecida Pimenta Santos Silva
