Surgery for Patients Undergoing Anticoagulant Therapy

Dental surgeries in patients under anticoagulant therapy are considered crucial and are done after careful monitoring of the patient's medical history and blood reports. This is due to the uncontrolled bleeding that is possible to occur following invasive treatment in such patients. Preoperative management of chronically anticoagulated patients and/or patients treated with antiplatelet therapy is a complex medical problem (1). More than half of all hematologists, oral surgeons, and maxillofacial surgeons surveyed in Ontario in 2005 routinely interrupted anticoagulation therapy for tooth extractions (2). Surveys from other countries report that many dental professionals are unaware of their patients' coagulation status, and still discontinue antiplatelet therapy unnecessarily (3). Thus In 1954, the American Heart Association recommended a therapeutic range for oral anticoagulant therapy of a prothrombin time ratio (PTR) of 2 ? 2.5 using human brain reagents (4). This article deals with the various methods available to avoid the uncontrolled bleeding following dental treatments in anticoagulated patients.