Hemostatic Mouthwashes in Anticoagulated Patients Undergoing Dental Extraction

@article{Patatanian2006HemostaticMI,
  title={Hemostatic Mouthwashes in Anticoagulated Patients Undergoing Dental Extraction},
  author={Edna Patatanian and Susan E. Fugate},
  journal={Annals of Pharmacotherapy},
  year={2006},
  volume={40},
  pages={2205 - 2210}
}
Objective: To evaluate the efficacy and safety of local acting hemostatic agents in patients who are undergoing dental extraction(s) and are taking oral anticoagulants. Data Sources: A search of MEDLINE (1966–July 2006), International Pharmaceutical Abstracts (1970–July 2006), and EMBASE (1966–July 2006) was conducted using the key terms anticoagulation, warfarin, hemostatic mouthwashes, epsilon aminocaproic acid, tranexamic acid, dental extraction, and oral surgery. Bibliographies of relevant… 
MANAGEMENT OF DENTAL EXTRACTIONS IN PATIENTS TAKING WARFARIN AS ANTICOAGULANT TREATMENT: A SYSTEMATIC REVIEW.
TLDR
There is no evidence to support or reject the superiority of local hemostatic agents over warfarin discontinuation, and patients with an INR within the therapeutic range can safely continue taking the regular dose of warfar in before dental extractions.
Dental extraction in the thrombocytopenic patient is safe and complications are easily managed.
  • W. Fillmore, Bryce D. Leavitt, K. Arce
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  • 2013
Postoperative bleeding after dental extraction in liver pretransplant patients.
  • J. Perdigão, P. D. De Almeida, F. Sousa
  • Medicine
    Journal of oral and maxillofacial surgery : official journal of the American Association of Oral and Maxillofacial Surgeons
  • 2012
The dental patient on oral anticoagulant medication: a literature review.
TLDR
To what extent a safe and successful dental treatment in patients on anticoagulant medication is feasible, the level of evidence is lacking and until high-level data are provided, an individualised treatment approach after consultation with the physician of the patient is highly recommended.
Safety and Efficacy of Ankaferd Blood Stopper in Dental Surgery
TLDR
ABS was topically applied by homogeneously spraying to the 25 patients during dental inter- ventions and no patient had wound infection and the healing process appeared to be normal.
Documentation of various approaches and outcomes in patients on warfarin undergoing dental procedures: a review article.
TLDR
Insight is provided into various approaches utilized by clinicians to deal with patients on warfarin undergoing dental procedures at a large teaching hospital in Riyadh and the frequency and severity of bleeding and thromboembolic complications during different types of dental procedures in this population.
Systemic and Topical Use of Tranexamic Acid in Spinal Surgery: A Systematic Review
TLDR
Use of topical TXA in surgery suggests similar hemostatic efficacy and potentially improved safety as compared with intravenous TXA, warranting further clinical investigation and consideration as a clinical option in cases with significant anticipated surgical site blood loss.
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References

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TLDR
Improved understanding of the importance of fibrinolytic mechanisms in the oral cavity has resulted in the development of various local measures to enable patients therapeutically anticoagulated with warfarin to be treated on an outpatient basis.
Tranexamic acid mouthwash versus autologous fibrin glue in patients taking warfarin undergoing dental extractions: a randomized prospective clinical study.
Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery.
TLDR
It is concluded that local antifibrinolytic therapy is effective in preventing bleeding after oral surgery in patients who are being treated with anticoagulants.
Prevention of postsurgical bleeding in oral surgery using tranexamic acid without dose modification of oral anticoagulants.
Use of tranexamic acid mouthwash to prevent postoperative bleeding in oral surgery patients on oral anticoagulant medication.
TLDR
The results indicated that a combination of local antifibrinolytic therapy and a local hemostatic agent is effective in preventing postoperative bleeding after oral surgery in patients treated with anticoagulants.
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TLDR
Although there is a theoretical risk of hemorrhage after dental surgery in patients who are at therapeutic levels of anticoagulation, the risk appears to be minimal, the bleeding usually can be easily treated with local measures, and this risk may be greatly outweighed by the risk of thromboembolism after withdrawal of antICOagulant therapy.
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