J Korean Assoc Oral Maxillofac Surg.  2020 Aug;46(4):228-234. 10.5125/jkaoms.2020.46.4.228.

Effect of warfarin discontinuation on the incidence of postoperative bleeding in tooth extraction

Affiliations
  • 1Department of Oral and Maxillofacial Surgery, National Health Insurance Service Ilsan Hospital, Goyang, Korea

Abstract


Objectives
The number of patients undergoing oral anticoagulant therapy for cardiovascular and cerebrovascular disease is increasing. However, the risk of bleeding after tooth extraction in patients receiving warfarin is unclear. Here, we assess the risk of bleeding after tooth extraction in patients on warfarin.
Materials and Methods
The study included 260 patients taking warfarin who underwent tooth extraction (694 teeth). The patients were divided into those whose teeth were extracted while they were taking warfarin, those who discontinued warfarin before extraction, and those who underwent extraction while receiving heparin bridging therapy. Bleeding complications in the two groups were compared.
Results
Of the 260 patients, 156 underwent extraction while taking warfarin, 70 stopped taking warfarin before extractions, and 34 received heparin bridging therapy and stopped taking either medication before extractions. Bleeding complications occurred in 9 patients (3.5%) and 9 tooth sites (1.3%). Among the 9 patients with bleeding complications, 6 underwent extraction while taking warfarin, 2 stopped warfarin before extraction, and 1 underwent extraction after receiving heparin bridging therapy. No significant difference was seen between patient groups regarding bleeding after extractions (p=0.917).
Conclusion
Warfarin use does not increase the risk of post-extraction bleeding and can therefore be continued during tooth extraction.

Keyword

Bleeding; Tooth extraction; Warfarin
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