When is the Best Time to Treat Patients on Blood Thinners? It is best to wait at least 12 hours after the patient takes a blood thinner before providing invasive care. Ask the patient what time of day the blood thinner is usually taken and book the dental appointment several hours (ideally >12 hours) later. How Can We Prevent Excessive Bleeding? • Good oral hygiene decreases inflammation, which will decrease bleeding and the need for invasive dental procedures. • Achieve hemostasis one tooth at a time. • Do not provide invasive care soon after a blood thinner was taken. • Get a medical consult asking if medications need to be temporarily discontinued if you expect unmanageable excessive bleeding. How Can We Manage Bleeding? • Pressure with gauze • Sutures • Resorbable hemostats • Other: local anaesthetic with epinephrine, tranexamic acid, tissue glue, bone wax, silver nitrate, electrocautery. Watch Dr. Mohanta’s video on managing patients on anticoagulant and antiplatelet medication on CDA Oasis: bit.ly/3QB8jCs DIRECT ACTING ORAL ANTICOAGULANTS (DOAC) AVAILABLE IN CANADA: z APIXABAN (SOLD UNDER THE BRAND NAME ELIQUIS) z EDOXABAN (LIIXIANA) z RIVAROXABAN (XARELTO) z DABIGATRAN (PRADAXA) ANTIPLATELETS ARE: z ASA, ALSO CALLED ACETYLSALICYLIC ACID (SOLD UNDER THE BRAND NAME ASPIRIN, ASAPHEN, ENTROPHEN, NOVASEN) z CLOPIDROGEL (PLAVIX) z PRASUGREL (EFFIENT) z TICAGRELOR (BRILINTA) References available upon request. 37 Issue 4 | 2024 | SupportingYour Practice
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