Direct Oral Anticoagulant Agents: Bleeding and Post-Operative Complications in the Outpatient Oral and Maxillofacial Surgery Setting

Abstract

Oral and maxillofacial surgeons are commonly called upon to treat an increasingly older patient population that is more medically complex than previously seen. Many surgeons perform dentoalveolar surgery on patients who take prescribed anticoagulant and/or antiplatelet medications. These anticoagulants may be used to prevent emboli in patients with chronic atrial fibrillation, thrombus formation in cardiac stents and valves, or recurrent thrombus in patients with DVTs. Anticoagulants provide clinical challenges to the dental community because discontinuing them prior to surgery may increase thromboembolic events, while treating patients without discontinuing them may result in increased bleeding during the perioperative period.