Abstract
Purpose: The aim of this study was to investigate the frequency of gingival bleeding (GB) and associated drug-withdrawal in atrial fibrillation (AF) patients using oral anti-coagulants (OAC).
 Materials and Methods: 457 patients with AF receiving OAC were screened. The periodontal parameters and OAC drug-withdrawal of 32 patients with spontaneous GB were compared with 32 patients without bleeding who were matched for age, sex and OAC treatment protocol.
 Results: GB was detected in 32 patients (7.0%) and 13 of these patients (40.6%) had OAC drug-withdrawal due to bleeding. The plaque index (PI), gingival index (GI) and probing pocket depths (PPD) were significantly higher in patients with GB. The GI scores independently determined the risk of OAC drug-withdrawal. 
 Conclusion: AF patients under OAC treatment may have significant rates of GB and subsequent OAC withdrawal due to pre-existing periodontal disease. The GI scores and GB can predict the risk of OAC drug-withdrawal. The periodontal examination and/or treatment of these patients should be performed before OAC treatment.
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