SDCEP - anticoagulant guidance

Question 1

patient is on a DOAC. low bleeding risk procedure guidance?

Answer 1

treat without interrupting medication
treat early in the day
limit initial tx and assess bleeding before continuing
stage extensive/ complex procedures

Question 2

patient is on a DOAC. high bleeding risk procedure guidance?

Answer 2

advise patient to miss or delay morning dose before tx
treat early in the day
limit initial tx and assess bleeding before continuing
consider staging extensive or complex procedures
strongly consider suturing and packing

Question 3

what must you check if a patient is taking a vitamin K antagonist?

Answer 3

INR - 24 hours prior to procedure

if INR below 4: treat without interrupting medication

if INR 4 or above: delay invasive rx or refer if urgent

Question 4

can you treat a patient as normal who is taking aspirin?

Answer 4

yes, treat without interrupting medication

Question 5

can you treat a patient as normal if taking clopidogrel?

Answer 5

treat without interrupting medication however expect prolonged bleeding

Question 6

list low risk dental procedures?

Answer 6

simple xla
incision and drainage of IO swellings
6ppc
RSD
direct/ indirect restorations with subgingival margins

Question 7

list higher risk dental procedures?

Answer 7

complex xla
flap raising
gingival recontouring
biopsies

Question 8

what are the DOACs?

Answer 8

apixaban
dabigatran
rivaroxaban
edoxaban

Question 9

what puts a patient at high risk of MRONJ?

Answer 9

taking bisphosphonates for more than 5 years
being concurrently treated with a steroid
taking denosumab/ taken in the last 9 months

Question 10

when should healing be reviewed if suspect MRONJ risk?

Answer 10

8 weeks