Anticoagulants/Antiplatelets Flashcards
Dental procedures unlikely to cause bleeding
LA
BPE
Supragingival PMPR
Endodontics
Direct/indirect restos with supra gingival margins
Dental procedures likely to cause low risk of bleeding
Simple XLa’s 1-3
Incise + drain
6PPC
Direct/indirect rests with subgingival margins
Dental procedures likely to cause high risk of bleeding
Complex XLa’s (adjacent/more than 3 at once)
Flap raising procedures - crown lengthening/biopsies/implants
General advice to anticoagulant/antiplatelet patients
Plan tx early in day/week
Tx traumatically, haemostatic measures
Post tx advice + emergency details
List patients we do not interrupt tx for
Pts with:
Prosthetic metal heart valves
Coronary stents
DVT or pulmonary embolism in last 3mths
Pts on anticoagulant therapy for cardioversion
Protocol for pt on Vit K antagonist (Warfarin)
Check INR no more than 24hrs before tx (72hrs if stable)
If INR <4 = tx without interrupting med
If INR>4 delay or refer
Protocol for pt on Apixaban or Dabigatran
2x day regular dose
Miss morning dose, take as usual in evening
Protocol for pt on Rivaroxaban
1x morning regular dose
Delay morning dose till 4hrs after
Protocol for pt on Edoxaban
1x day evening
Take usual time
Protocol for pt on Aspirin
Tx without interrupting
Protocol for patient on Clopidogrel
Tx without interrupting
