Dental treatment in the era of new anti-thrombotic agents

Int Dent J. 2018 Jun;68(3):131-137. doi: 10.1111/idj.12322. Epub 2017 Sep 17.

Abstract

Background: In recent years, there have been dramatic changes in anti-thrombotic treatment as a result of new anti-thrombotic agents, as well as changes in the indications for their use. As a consequence, dentists are encountering larger numbers of patients who are undergoing anti-thrombotic treatment and who have increased risk for bleeding. The current paper aims to review the literature regarding up-to-date anti-thrombotic treatment and provide information regarding their implications on dentistry.

Methods: An online search was performed of the literature published between 2000 and 2016. Articles dealing with evidence-based clinical guidelines for anti-thrombotic treatments, as well as literature reporting the use of anti-thrombotic medications were included. The manuscripts were screened according to their relevance to dentistry as well as their treatment protocol guidelines.

Results: In total, 5,539 publications were identified: 56 of 554 evidence-based clinical guidelines were found that dealt with treatment protocols with anti-thrombotic agents; and 132 of 5,539 articles describe direct anti-thrombotic medications.

Clinical implications: Dental treatment includes a risk for bleeding. As a result of the increasing number of patients taking new-generation anti-thrombotic drugs, dentists must be up to date regarding the implications of such drugs on dental treatment as well as the practical means to achieve haemostasis.

Keywords: Oral surgery; new anti-thrombotic drugs; postoperative bleeding; thromboembolic events.

Publication types

  • Review

MeSH terms

  • Clinical Protocols
  • Dental Care / adverse effects*
  • Dental Care / methods*
  • Fibrinolytic Agents / adverse effects*
  • Fibrinolytic Agents / pharmacology
  • Fibrinolytic Agents / therapeutic use*
  • Hemostatic Techniques
  • Humans
  • Oral Hemorrhage / etiology*
  • Oral Hemorrhage / prevention & control*
  • Pharmaceutical Research
  • Practice Guidelines as Topic

Substances

  • Fibrinolytic Agents