Risk of postoperative bleeding after dental procedures in patients on warfarin: A retrospective study

Abstract

Objectives: The purpose of this retrospective study was to investigate the frequency of bleeding complications after invasive dental procedures in warfarinized patients and the possible risk factors. Study Design: The CoaguChek System was used to obtain an in-office international normalized ratio (INR) value for 122 patients (240 appointments), of which the mean age was 57.0 ± 15.9 years and 50% were males. Demographic and clinical information were obtained retrospectively from dental and medical records. Results: Five episodes (mean INR: 2.0 ± 0.8) of persistent bleeding were identified; 4 were after extractions and 1 was after implant placement. The frequency of bleeding was 4.8%, if only considering surgical procedures. Postoperative bleeding was significantly higher (P <.05) in patients who were taking anti-thrombotic medications in addition to warfarin. Conclusions: There is a low incidence of persistent bleeding after invasive dental procedures in warfarinized patients but the risk appears to increase with the use of concomitant anti-thrombotic medications. © 2012 Elsevier Inc. All rights reserved.