ArticleResearch and practice in thrombosis and haemostasis2020
Dental extractions on direct oral anticoagulants vs. warfarin: The DENTST study.
Article in Research and practice in thrombosis and haemostasis, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Clinical practice guideline of the spanish society of oral surgery for oral surgery in patients with coagulation disorders.Medicina oral, patologia oral y cirugia bucal · 2024Guideline
- Local Hemostasis as the Critical Enabler for Safe Antithrombotic Therapy in Dentistry-Navigating Future Frontiers and Innovative Concepts.Journal of clinical medicine · 2026Review
- Risk of bleeding with dentoalveolar surgery in patients taking direct oral anticoagulants or vitamin K antagonists: A systematic review and meta-analysis.The Japanese dental science review · 2025Review
- Continuous use of direct oral anticoagulants during and after simple and surgical tooth extractions: a prospective clinical cohort study.BMC oral health · 2025Observational
- Oral anticoagulant periprocedural management in patients undergoing an oral, dental implant or periodontal surgery: a prospective national observational survey.Research and practice in thrombosis and haemostasis · 2025Article
- Direct Oral Anticoagulants and Bleeding Management Following Tooth Extractions-A Prospective Cohort Study.Dentistry journal · 2024Article
- Factors influencing postoperative bleeding after dental extraction in older adult patients receiving anticoagulation therapy.Clinical oral investigations · 2023Article
- Edoxaban use in the context of dental procedures: analysis from the EMIT-AF/VTE database.BDJ open · 2023Article
- Systematic review on the effects of the discontinuation of the anticoagulant therapy and the postoperative bleeding, in patients under new oral anticoagulants after dental extraction.Journal of clinical and experimental dentistry · 2023Review
- Perioperative management of antithrombotic therapy: a case-based narrative review.Internal and emergency medicine · 2022Review
- Consideration of NOACs (novel or non-vitamin K-dependent oral anticoagulants) in dental procedure.Journal of the Korean Association of Oral and Maxillofacial Surgeons · 2021Article
- Comparative Risk of Bleeding of Anticoagulant Therapy with Vitamin K Antagonists (VKAs) and with Non-Vitamin K Antagonists in Patients Undergoing Dental Surgery.Journal of clinical medicine · 2021Review
- A prospective comparative study to assess the risk of postoperative bleeding after dental surgery while on medication with direct oral anticoagulants, antiplatelet agents, or vitamin K antagonists.BMC oral health · 2021Article
- Postoperative bleeding after dental extraction among elderly patients under anticoagulant therapy.Clinical oral investigations · 2021Article
- Bleeding Complications in Anticoagulated and/or Antiplatelet-Treated Patients at the Dental Office: A Retrospective Study.International journal of environmental research and public health · 2021Article
- Bleeding Outcomes After Dental Extraction in Patients Under Direct-Acting Oral Anticoagulants vs. Vitamin K Antagonists: A Systematic Review and Meta-Analysis.Frontiers in pharmacology · 2021Review
- Dental extractions on direct oral anticoagulants vs. warfarin: The DENTST study.Research and practice in thrombosis and haemostasis · 2020Article
Corrections and comments
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundConflicting recommendations exist addressing the management of direct oral anticoagulants (DOACs) for invasive dental procedures.
objectivesTo determine the safety of DOAC continuation compared to warfarin continuation for dental extractions with regards to bleeding outcomes.
methodsA single-center, prospective, cohort study was performed to compare 7-day bleeding outcomes between patients who continued their DOAC, and patients on warfarin with an International Normalized Ratio (INR) between 2.0 and 4.0. Blood tests including oral anticoagulant drug levels were measured immediately prior to extraction. The gauze used to apply pressure to the socket was weighed before and after extraction to estimate blood loss. Patients were contacted by phone 2 and 7 days after extraction.
resultsEighty-six patients on a DOAC had a total of 145 teeth extracted, and 21 patients on warfarin had 50 teeth extracted. There were no major bleeding events. The rate of minor plus clinically relevant nonmajor bleeding was comparable between the DOAC and warfarin cohorts (36% and 43%, respectively; odds ratio, 0.75; 95% confidence interval, 0.29-1.98). Preextraction apixaban and dabigatran levels were comparable between bleeders and nonbleeders, while rivaroxaban levels were higher in those who bled. The weight change of gauze used to tamponade the socket was similar between the 2 cohorts.
conclusionDental extractions on patients continuing DOACs led to bleeding rates similar to patients on warfarin with an INR between 2.0 and 4.0. There is no need to adjust DOAC dosing prior to dental extractions.
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