Dentists' approach to patients on anti-platelet agents and warfarin: a survey of practice

Abstract

In everyday practice, dentists are confronted with the dilemma of patients on anti-platelet agents and warfarin who require invasive dental procedures and, more pertinently, dental extractions. There may be a divergence of opinion among dentists regarding how they manage these patients.

Aims: To assess general dental practitioners' approach to the management of patients taking anti-platelet agents and/or warfarin who are undergoing invasive dental procedures.

Methods and data: A semi-structured questionnaire was designed to survey general dental practitioners in a large Irish urban area.

Results: A response rate of 89% was achieved in a study population of 54 general dental practitioners. A total of 25% of respondents who carry out extractions on warfarinised patients do not check the INR prior to invasive dental procedures. Some 90% of respondents stop anti-platelet agents prior to extractions.

Conclusions: A significant proportion of respondents fail to check warfarinised patients' INR prior to invasive dental procedures. Furthermore, a trend of stopping anti-platelet agents was noted, which is in contrast with current recommendations in the dental literature. Certain practices in this small study population proved alarming and highlight the need for improved awareness of current guidelines. A further large-scale study may be justified, as variation in practice may have clinical and medico-legal repercussions.