Anticoagulation Services

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• Venous Thromboembolism (Diagnosis, Prevention Treatment)
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• Neuroaxial Anesthesia in the Anticoagulated Patient
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Suggestions for anticoagulation management before and after dental procedures

Management of anticoagulation before and after dental procedures requires careful, patient-specific evaluation of the risk of bleeding associated with the dental procedure as well as the risk of thromboembolism associated with the underlying disease state for which anticoagulation is indicated. Patient specific management plans will be made in consultation with the dentist performing the procedure.

	Low Bleeding Risk	Moderate Bleeding Risk	High Bleeding Risk
Procedures	Supraginival scaling Simple restorations Local anesthetic injections	Subginival scaling Restorations with subgingival preparations Standard root canal therapy Simple extractions Regional injections of local anesthetics	Extensive surgery Apicoectomy (root removal) Alevolar surgery (bone removal) Multiple extractions
Suggestions	Do not interrupt warfarin tx Use local measures to prevent or control bleeding	Interruption of warfarin therapy in not necessary Use local measures to prevent or control bleeding Consult w/ dentist to determine comfort with use of local measures to prevent bleeding when anticoagulation is not interrupted	May need to reduce INR or return to normal hemostasis Follow “Suggestions for Anticoagulation Management Before and After Invasive Procedures” Use "Local methods to prevent or control bleeding"

 

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