Dental considerations in patients on antiplatelet and anticoagulant drugs – Clearing the fog: A case series

Abstract

The use of antiplatelet and anticoagulant drugs is increasing day by day. Hence, recently dentists are coming across a greater number of patients on such medications. Dentists should have in-depth knowledge about the indications, bleeding complications, postoperative instructions, and antidotes of these drugs on oral health and therapy. The dental surgeon should also be aware of the consequences of withdrawal or continuation of these drugs on life-threatening thromboembolic events or bleeding complications. The present observational study included 1240 cardiac patients who were on antithrombotic therapy. Out of which 78 patients underwent various dental procedures involving probable bleeding complications, 11 patients met with bleeding complications, and 2 patients of which reported spontaneous bleeding. This case series reports bleeding complications associated with dental procedures (either procedure-related or spontaneous oral bleeding) in patients with drug-induced coagulopathies (patients either on antiplatelet or anticoagulant or on both). A description of the medical conditions of these patients along with a regimen of antithrombotic therapy is discussed. Management of bleeding complications is also described. These case series recommend continuing antiplatelet or anticoagulant therapy during dental procedures to prevent the risk of life-threatening conditions owing to thromboembolic complications. Simultaneously, the necessary armamentarium to deal with bleeding complications should be readily available.