Our Summary

This research paper looks at how much people bleed during dental extractions, specifically those who take blood thinners known as direct oral anticoagulants (DOACs). The researchers measured the amount of bleeding during surgery and for seven days afterward. They compared the results from three groups: patients on DOACs, patients on a different type of blood thinner (vitamin K antagonists or VKAs), and patients not on any blood thinners.

The results showed that none of the patients on DOACs experienced bleeding events during their procedures. In comparison, a few procedures in the other two groups required additional steps to stop the bleeding. However, the overall amount of bleeding in the DOAC and VKA groups was similar.

The findings suggest that taking DOACs doesn’t increase the amount of bleeding during or after dental extractions.

FAQs

  1. Did the research find any increased bleeding in patients taking direct oral anticoagulants (DOACs) during dental extractions?
  2. How did the amount of bleeding compare between patients on DOACs and those on vitamin K antagonists (VKAs)?
  3. Did any patients require additional steps to stop the bleeding during their dental extraction procedures?

Doctor’s Tip

A helpful tip a doctor might tell a patient about oral surgery is to continue taking their prescribed medications, including blood thinners, as instructed by their healthcare provider. It is important to communicate with your oral surgeon about all medications you are taking to ensure a safe and successful procedure.

Suitable For

Patients who may be recommended oral surgery include those with impacted teeth, severe tooth decay, gum disease, infections, jaw misalignment, facial trauma, or need for dental implants. Additionally, patients with certain medical conditions such as sleep apnea, temporomandibular joint disorders, or oral cancer may also require oral surgery. Oral surgery may also be recommended for patients who need wisdom teeth removal or corrective jaw surgery. Overall, the decision to recommend oral surgery is based on the individual patient’s oral health needs and medical history.

Timeline

Timeline before oral surgery:

  • Consultation with oral surgeon to discuss treatment plan and potential risks
  • Pre-operative instructions given, such as fasting before surgery and medication adjustments
  • Patient may undergo pre-operative tests such as blood work or imaging
  • Patient may be prescribed antibiotics or other medications to prevent infection
  • Patient may be instructed to stop taking certain medications, such as blood thinners, before surgery

Timeline after oral surgery:

  • Patient is monitored closely in recovery room for any immediate complications
  • Patient may experience some pain, swelling, and bleeding in the days following surgery
  • Patient is given post-operative instructions, such as how to care for the surgical site and manage pain
  • Patient may need to follow a soft diet or avoid certain activities for a period of time
  • Follow-up appointments scheduled to monitor healing and address any concerns

What to Ask Your Doctor

Some questions a patient should ask their doctor about oral surgery include:

  1. Will my current medications, including any blood thinners like DOACs, affect the surgery or my recovery?
  2. What steps will be taken to minimize bleeding during and after the surgery?
  3. How long should I expect to experience bleeding after the surgery, and what signs should I watch for that indicate excessive bleeding?
  4. Are there any specific post-operative care instructions I should follow to help prevent bleeding complications?
  5. What should I do if I experience prolonged or excessive bleeding after the surgery?
  6. Are there any alternative medications or treatments that could be used in place of my current blood thinners during the surgery?
  7. Will I need to adjust my dosage of blood thinners before or after the surgery, and if so, how should I do this?
  8. How soon after the surgery can I resume taking my blood thinners?
  9. Are there any specific risks or complications associated with taking blood thinners like DOACs during oral surgery?
  10. What are the potential benefits of continuing my blood thinners during the surgery, and are there any risks associated with stopping them temporarily?

Reference

Authors: Rocha AL, Oliveira SR, Souza AF, Travassos DV, Abreu LG, Ribeiro DD, Silva TA. Journal: Minerva Stomatol. 2020 Dec;69(6):384-393. doi: 10.23736/S0026-4970.20.04389-7. Epub 2020 Jul 21. PMID: 32698567