Anticoagulation and minor oral surgery: Should the anticoagulation regimen be altered?

Purpose: This study was performed to assess the extent of bleeding in anticoagulated patients undergoing minor oral surgery procedures when compared with patients who stop their anticoagulation regimen before surgery and patients who have never been anticoagulated. Materials and Methods: Patients on anticoagulant medications undergoing dentoalveolar surgery procedures either stopped their anticoagulation regimen 72 to 96 hours before the planned surgical intervention or continued their regular regimen throughout the time of surgery. Blood loss was measured by weighing sponges used in the procedures, and groups were compared for differences in blood loss. They were also compared with an additional control group that had never been on anticoagulant therapy. Results: There was no difference in blood loss detected among any of the experimental or control groups. No bleeding complications occurred in any anticoagulated patient. Conclusions: The data suggest that many patients can safely undergo routine outpatient oral surgical procedures without alteration of their regular therapeutic anticoagulation regimens and without additional medical intervention. However, a larger experimental population may be needed to elucidate the appropriateness of this approach to perioperative care.