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BMC Oral Health
Published in: BMC Oral Health 1/2016

Open Access 01-12-2016 | Debate

Managing patients taking novel oral anticoagulants (NOAs) in dentistry: a discussion paper on clinical implications

Authors: Fulvia Costantinides, Roberto Rizzo, Lorenzo Pascazio, Michele Maglione

Published in: BMC Oral Health | Issue 1/2016

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Abstract

Background

The aim of this paper is to contribute to the discussion on how to approach patients taking new orally administered anticoagulants (NOAs) dabigatran etexilate (a direct thrombin inhibitor), rivaroxaban and apixaban (factor Xa inhibitors), before, during and after dental treatment in light of the more recent knowledges.

Discussion

In dentistry and oral surgery, the major concerns in treatment of patients taking direct thrombin inhibitors and factor Xa inhibitors is the risk of haemorrhage and the absence of a specific reversal agent. The degree of renal function, the complexity of the surgical procedure and the patient’s risk of bleeding due to other concomitant causes, are the most important factors to consider during surgical dental treatment of patients taking NOAs. For patients requiring simple dental extraction or minor oral surgery procedures, interruption of NOA is not generally necessary, while an higher control of bleeding and discontinuation of the drug (at least 24 h) should be requested before invasive surgical procedures, depending on renal functionality.

Summary

The clinician has to consider that the number of patients taking NOAs is rapidly increasing. Since available data are not sufficient to establish an evidence-based dental management, the dentist must use caution and attention when treating patients taking dabigatran, rivaroxaban and apixaban.
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Metadata
Title
Managing patients taking novel oral anticoagulants (NOAs) in dentistry: a discussion paper on clinical implications
Authors
Fulvia Costantinides
Roberto Rizzo
Lorenzo Pascazio
Michele Maglione
Publication date
01-12-2016
Publisher
BioMed Central
Published in
BMC Oral Health / Issue 1/2016
Electronic ISSN: 1472-6831
DOI
https://doi.org/10.1186/s12903-016-0170-7

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