Minor oral surgical procedures in patients on oral anticoagulants - a controlled study

Background: Patients on therapeutic anticoagulation are at risk of bleeding from minor oral surgical sites. When the anticoagulant regime is modified to prevent the risk of bleeding this at the same time predisposes the patient to risks of the medical condition for which they are being treated. Methods: A total of 70 patients who were on warfarin treatment requiring minor oral surgical procedures were treated in the Oral Surgery Department. A control group of 35 had their warfarin stopped prior to the minor oral surgical procedure. The other 35 formed the study group. Patients With an International Normalized Ratio outside the the therapeutic range of 2-4, or with history of liver disease or on drugs affecting liver function were excluded from the study. Any incidences of post-operative bleeding were recorded. Results: None of the patients in either control or study group had any serious bleeding complications. Conclusion: The data suggest that patients can safely undergo routine minor oral surgical procedures without alterations of their therapeutic anticoagulation regime.