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Protocol in managing oral surgical patients taking dabigatran

A selection of abstracts of clinically relevant papers from other journals. The abstracts on this page have been chosen and edited by John R. Radford.

Abstract

Compared with warfarin, dabigatran '...allows a fixed dose regimen in most patients without the need for routine monitoring of anticoagulant effects.'

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Breik O, Cheng A et al. Aust Dent J 2014; 59: 296–301

There are important implications for dentists, for those patients taking dabigatran. At the heart of this paper is a case series. Three patients taking dabigatran for atrial fibrillation, received single tooth extractions without significant post-operative bleeding and no alteration to this drug regimen. Another patient received multiple extractions, also without complications. For this patient, dabigatran was stopped pre-operatively. The other patient in this series experienced serious postoperative bleeding following extraction of 18 teeth and drainage of an abscess. Bleeding was controlled after the patient was returned to theatre, further sutures placed and dabigatran was stopped. Much of the discussion is focused on risk assessment; 'Intraoral bleeding can often be managed and is rarely catastrophic, but a stroke can be permanently debilitating.' Stopping dabigatran, or any anticoagulant, must only be directed by the patient's general medical practitioner or cardiologist. As there is currently no effective reversal agent for dabigatran, this drug can be cleared only with dialysis.

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Protocol in managing oral surgical patients taking dabigatran. Br Dent J 217, 575 (2014). https://doi.org/10.1038/sj.bdj.2014.1027

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  • DOI: https://doi.org/10.1038/sj.bdj.2014.1027

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