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Bleeding related to dental treatment in patients taking novel oral anticoagulants (NOACs): a retrospective study

 Eun-Jung Kwak  ;  Sangook Nam  ;  Kyeong-mee Park  ;  Seo-yul Kim  ;  Jisun Huh  ;  Wonse Park 
 CLINICAL ORAL INVESTIGATIONS, Vol.23(1) : 477-484, 2019 
Journal Title
Issue Date
Administration, Oral ; Adult ; Aged ; Aged, 80 and over ; Anticoagulants/administration & dosage* ; Dental Care for Chronically Ill* ; Female ; Humans ; Male ; Middle Aged ; Postoperative Hemorrhage/chemically induced* ; Retrospective Studies ; Risk Factors
Bleeding ; Dental treatment ; Direct oral anticoagulant ; Novel oral anticoagulants
OBJECTIVE: Several novel oral anticoagulants (NOACs) are currently prescribed for patients suffering from atrial fibrillation, pulmonary thromboembolism, and venous thrombosis. However, there is no clinical guideline for dental treatment in patients taking NOACs. This study investigated bleeding events related to various dental treatments. MATERIALS AND METHODS: This retrospective study included 120 patients (153 cases) who were prescribed NOACs and received dental procedures in the Department of Advanced General Dentistry at Yonsei University Dental Hospital from January 2014 to June 2017. The indication for NOACs, initiation of NOACs, duration of discontinuance, creatinine clearance, and type of dental treatment were investigated. Bleeding events were assessed at a follow-up visit to the clinic. RESULTS: Postoperative bleeding occurred in only 9 of the 153 included cases; they comprised 2 cases of scaling, 3 cases of simple extraction, 3 cases of the first stage of implant surgery, and 1 case of resin filling. The creatinine clearance (P = .111) and duration of discontinuance (P = .222) did not differ significantly between the groups with and without bleeding events. CONCLUSIONS: Our data indicate that most dental treatments may be performed in patients taking NOACs without an increased likelihood of bleeding events regardless of the discontinuance duration. Moreover, any postoperative bleeding can be stopped by applying compressive pressure or local hemostatic agents. CLINICAL RELEVANCE: Our study suggests that patients taking NOACs who need dental treatments may have a bleeding tendency based on our retrospective data. Preoperative history taking and treatment modification should therefore be considered before performing dental surgery.
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2. College of Dentistry (치과대학) > Dept. of Advanced General Dentistry (통합치의학과) > 1. Journal Papers
2. College of Dentistry (치과대학) > Others (기타) > 1. Journal Papers
Yonsei Authors
Park, Wonse(박원서) ORCID logo https://orcid.org/0000-0002-2081-1156
Huh, Jisun(허지선) ORCID logo https://orcid.org/0000-0001-5514-187X
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