Clinical Implication of the New Anticoagulants in Dentistry

Abstract Currently, there is no validated monitoring technique for predicting bleeding risk in direct oral anticoagulant (DOAC) patients, and the dental literature is based largely on case reports and expert views. This study aims at addressing the following questions: “Should they be stopped before the procedure?” and “What is the correct protocol to follow while ingesting DOACs?” There are presently no dental treatment standards for patients using new oral anticoagulants, and bleeding management recommendations are mainly based on professional opinions and clinical observations rather than well conducted studies or laboratory results. Some of the first DOACs were rivaroxaban, apixaban, edoxaban, and dabigatran. DOACs are now being used to treat patients who were previously taking conventional anticoagulants, and as a result, more dentists will be treating DOAC patients. There is currently no validated monitoring test for estimating bleeding risk in DOAC patients, and the dental literature is primarily on case reports and expert opinions. Prior to dental treatment, it is uncertain whether the DOACs should be continued, partially discontinued for 1 day, or fully interrupted for more than 2 days.