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

BMC Oral Health

Debate

Michele Maglione¹  Roberto Rizzo¹  Fulvia Costantinides¹  Lorenzo Pascazio² 

[1] School of Specialization in Oral Surgery, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy;Unit of Geriatrics, Department of Medical, Surgical and Health Sciences, University of Trieste, Trieste, Italy;

关键词: Novel oral anticoagulants;    Dabigatran;    Rivaroxaban;    Apixaban;    Dental treatment;   

DOI  :  10.1186/s12903-016-0170-7

 received in 2015-05-20, accepted in 2016-01-25,  发布年份 2016

来源: Springer

【 摘 要 】

BackgroundThe 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.DiscussionIn 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.SummaryThe 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 management, the dentist must use caution and attention when treating patients taking dabigatran, rivaroxaban and apixaban.

【 授权许可】

CC BY   
© Costantinides et al. 2016