Knowledge of Practicing Students and Dental Surgeons Regarding Anti- coagulation Therapy of Patients Undergoing Dental Extractions

Authors

  • Abdul Manan Shahid Department of Oral Medicine, Islamabad Medical & Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad.
  • Muhammad Jamal Department of Oral & Maxillofacial Surgery, Capital Hospital, Islamabad.
  • Khalid Mahmood Siddiqi Department of Oral & Maxillofacial Surgery, Islamabad Medical & Dental College, Shaheed Zulfiqar Ali Bhutto Medical University, Islamabad.
  • Muhammad Mudassar Saleem Department of Oral and Maxillofacial Surgery, Dental Centre, Yanbu General Hospital, Yanbu, Ministry of Health, Kingdom of Saudi Arabia.
  • Muhammad Zeeshan Baig Department of Oral & Maxillofacial Surgery, Frontier Medical & Dental College, Abbottabad

DOI:

https://doi.org/10.47489/szmc.v38i2.453

Keywords:

Bleeding disorder, Anticoagulant, Hemophilia, Factor deficiency, von Willebrand disease

Abstract

Introduction: Dentists are still confused about whether to stop anticoagulants during extractions or to practice local hemostatic measures and closely monitor patients' international normalized ratios (INR) levels.

Aims & Objectives: To determine and analyze the level of knowledge of practicing students and dental surgeons regarding anticoagulation therapy of patients undergoing dental extractions.

Place and Duration of Study: A descriptive cross-sectional study was conducted among dentists and dental students in a teaching dental hospital (Islamabad Dental Hospital) for 5 months between August to December 2021.

Material & Method: There were a total of 127 participants including BDS students, house officers, postgraduate trainees, and faculty members of all dental clinical departments who responded to the printed questionnaire. A convenience sampling technique was used to gather the data. After encoding, the data was input into SPSS version 22. For qualitative variables, mean and standard deviation were computed, whereas for quantitative variables, frequencies and percentages were determined., p.value? 0.05 was considered significant. The findings were displayed as tables, charts, and figures.

Results: Out of 127 participants, 63.7% (n=81/127) were in favor of consultation with the patient's physician before dental extractions whereas 59% (n=75/127) considered discontinuation of aspirin seven days before extractions. Different international normalized ratio (INR) levels were considered for different medical conditions by 78.7% (n=100/127) while 49.6% (n=63/127) of the participants believed that warfarin should be replaced with low molecular weight heparin before dental extractions. 79% of participants knew the antidote of heparin. Postoperative clot formation was not checked by 25.2% (n=32/127), and 87.4% (n=111/127) gave both verbal and written instructions after dental extractions.

Conclusion: It is concluded that there is a good level of awareness and implementation of guidance among dental practitioners. Further research and training programs are advised to enhance the knowledge among dental practitioners and to upgrade the standard protocols for treating patients with anticoagulation therapy.

References

Manfredini M, Poli PP, Creminelli L, Porro A, Maiorana C, Beretta M. Comparative risk of bleeding of anticoagulant therapy with vitamin K antagonists (VKAs) and with non-vitamin K antagonists in patients undergoing dental surgery. J Clin Med. 2021; 10(23): 5526.

Tokarek T, Homaj M, Zabojszcz M, Dolecka- ?lusarczyk M, Szotek M, Sabatowski K, Loster B, Bartu? S, Siudak Z. Knowledge on the guideline- recommended use of antiplatelet and anticoagulant therapy during dental extractions: a contemporary survey among Polish dentists. Kardiol Pol (Polish Heart Journal). 2020;78(11):1122-8.

Nisi M, Carli E, Gennai S, Gulia F, Izzetti R. Hemostatic agents for the management of bleeding risk associated with oral anticoagulant therapy following tooth extraction: a systematic review. Applied Sciences. 2022 Oct 31;12(21):11017..

Wójcik S, Mocny-Pacho?ska K, Bisch-Wójcik S, Balicz A, Morawiec T. Perioperative management of dental surgery patients chronically taking antithrombotic medications. Int J Environ Res Public Health.2022;19(23):16151.https://doi.org/10.3390/i jerph192316151

Adel Alenazi. Dental management of patients on chronic oral anticoagulants: a review. J Res Med Dent Sci . 2020 8(1): 120-4.

Chahine J, Khoudary MN, Nasr S. Anticoagulation use prior to common dental procedures: a systematic review. Cardiol Res Pract. 2019 JUN 2;2019:9308631. doi: 10.1155/2019/9308631.

Ahmed I, Younis M, Shah AA. Extraction in patients on oral anticoagulant therapy with and without stopping the drug: a comparative study. J Maxillofac Oral Surg. 2019 ;18:555-8.

Martínez-Moreno E, Martínez-López F, Rodríguez- Lozano FJ, Oñate-Sánchez RE. Bleeding complications in anticoagulated and/or antiplatelet- treated patients at the dental office: a retrospective study. Int J Environ Res Public Health. 2021;18(4):1609. doi.org/10.3390/ijerph18041609

Gaballah K, Hassan M. Knowledge and practice of dentists managing patients on antithrombotic medications: a cross-sectional survey. Eur J Dent. 2022 ;16(04):775-80.

Haris M, Ashar A, Imtiaz M. Knowledge of dentists regarding management of orally anticoagulated patients undergoing dental extractions. Pak Oral Dent J. 2016; 36(4):538-41.

Ibdah RK, Rawashdeh SI, Harahsheh E, Almegdadi A, Ksassbeh AA, Alrabadi N. The knowledge and perception of antiplatelet and anticoagulant agents among dentists in Northern Jordan. J Int Soc of Prev Community Dent. 2020 ;10(5):597-604.

Chinnaswami R, Bagadia RK, Mohan A, Kandaswamy E, Chandrasekaran D. Dentists’ knowledge, attitude and practice in treating patients taking oral antithrombotic medications–a survey. J clin and diagnostic Res: 2017; 11(1): 88-91.

Kelly, N., Beaton, L., Knights, J. et al. The practices and beliefs of dental professionals regarding the management of patients taking anticoagulant and antiplatelet drugs. BDJ Open 9, 1 (2023). doi.org/10.1038/s41405-022-00127-3.

Al-Sebaei M, Sindi MA. A knowledge and practice survey among dentists in Saudi Arabia nalysing myths and misconceptions in dentistry and oral surgery: what do dentists believe?. Cureus. 2023; 15(3): e36625. DOI 10.7759/cureus.36625.

Ashraf T, Ishaq M. Oral anticoagulants: challenges in Pakistan. do we have a solution?. Pak Heart J. 2021;54(02):124-125.DOI: https://doi.org/10.47144/phj.v54i2.2085

Al-Sheef M, Gray J, AlShammari A. Risk of postoperative bleeding following dental extractions in patients on antithrombotic treatment. Saudi Dent J. 2021;33(7):511-7.

Felix J, Chaban P, Ouanounou A. Dental management of patients undergoing antithrombotic therapy. J Can Dent Assoc. 2020;86(k17):1488- 2159.

Shenoi RS, Rajguru JG, Parate SR, Ingole PD, Khandaitkar SR, Karmarkar JS. Compliance of postoperative instructions following the surgical extraction of impacted lower third molars. Indian J Dent Res. 2021;32(1):87-91.

Jain P, Jain AK, Patidar M, Banthia R, Batham PR. Dental considerations in patients on antiplatelet and anticoagulant drugs–clearing the fog: a case series. J Datta Meghe Inst Med Sci Univ. 2023;18(1):114-9.

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Published

2024-04-29

How to Cite

1.
Abdul Manan Shahid, Muhammad Jamal, Khalid Mahmood Siddiqi, Muhammad Mudassar Saleem, Muhammad Zeeshan Baig. Knowledge of Practicing Students and Dental Surgeons Regarding Anti- coagulation Therapy of Patients Undergoing Dental Extractions. Proceedings S.Z.M.C [Internet]. 2024 Apr. 29 [cited 2024 May 17];38(2):85-9. Available from: http://www.proceedings-szmc.org.pk/index.php/szmc/article/view/453