Warfarin
Anticoagulant (vitamin K antagonist)
Brand names: Coumadin, Jantoven
Oral health effects
Prolonged / increased bleeding
Increased bleeding tendency during and after invasive dental procedures (extractions, scaling and root planing, surgery). Check a recent INR before invasive treatment; most procedures are safe at a therapeutic INR (≤3.5) without interrupting therapy.
Mechanism: Inhibition of vitamin K–dependent clotting factor synthesis.
Clinical management: Use local hemostatic measures (pressure, sutures, oxidized cellulose, tranexamic acid mouthwash). For most procedures, do not interrupt therapy without physician consultation; plan early-day, atraumatic treatment.
Sources
- MANAGEMENT OF DENTAL EXTRACTIONS IN PATIENTS TAKING WARFARIN AS ANTICOAGULANT TREATMENT: A SYSTEMATIC REVIEW. Weltman NJ, Al-Attar Y, Cheung J, et al. Journal (Canadian Dental Association), 2015.