Abdul Wahid, Syed Amjad Shah, Shahjehan Katpar, Muhammad Raza.
Interruption of warfarin before dental surgery.
Pak Oral Dental J Jan ;36(1):22-5.

Objective was to find out whether interruption of warfarin before undergoing dental surgery is necessary and to determine the effects of stopping pre-operative warfarin in Patients undergoing minor oral surgical procedures. After taking full medical history, clinical examination and an orthopantogram, randomization was then done by convenience sample technique. A preoperative International Normalized Ratio (INR) and coagulation screen were arranged, with Consent on the day of dental surgery. The group I continued taking warfarin as usual (anticoagulant group). The group II stopped taking warfarin 2 days before their dental surgery procedure. If a patient’s INR was >2, a further dose of warfarin was omitted. The dental surgery was performed under local anesthesia. Oral antibiotic prophylaxis was given for patients at risk of endocarditis in both groups. Two hundred and eighteen patients form the study group. 114 were to the anticoagulant group (Group I) and104 to the warfarin withdrawn group (Group II). There were no significant differences between the groups in the mean age, gender, number of teeth extracted. Mean INR for the group I was > 2.5 than the group II, at 1.6 (p=0.001). The overall rate of bleeding complications in the group I was higher than in the group II (30% compared with 14%). It is concluded that the minor oral surgical procedures can be done without discontinuing the warfarin.

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