Antithrombotic therapy in dental practice

Abstract

Antithrombotic therapy is a therapeutic method aimed at preventing the development of thrombosis. It mainly includes antiplatelet therapy, which includes drugs such as aspirin, and anticoagulant therapy, including drugs such as warfarin. Recently, patients on antithrombotic drugs, especially direct oral anticoagulants, often require frequent dental visits. Additionally, antithrombotic patients, especially those with a chief complaint of postoperative bleeding or traumatic or sudden bleeding, often have many opportunities for receiving treatment by oral surgery. In these cases, thrombosis involves local hemostasis by principle; however, hemostasis and rebleeding often occur. Before scheduling surgery for patients on antithrombotic therapy, it is essential for the dental surgeon to cooperate with the patient’s attending physician to discuss methods for ensuring surgical hemostasis. However, traumatic or sudden bleeding can occur in these patients even after admitted local hemolytic difficulty, requiring the need for systemic hemostasis. Herein, we summarize the findings based on the recent guidelines presented by dental field and related academic societies for the management of postoperative and traumatic bleeding that may be encountered in a dental clinic.