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Management of patients taking anticoagulants or antiplatelet drugs

The treatment of patients taking anticoagulant or antiplatelet medication raises safety issues in terms of the potential risk of bleeding complications following invasive dental procedures. The anticoagulant warfarin, and the antiplatelet agents aspirin and clopidogrel, have been widely used for many years and most dental practitioners will be familiar with established guidelines and local protocols for the dental care of patients taking these drugs.

However, in recent years several newer oral anticoagulants (NOACs; Novel Anticoagulant or Non-vitamin K antagonist Oral Anticoagulants) and antiplatelet drugs have become available in the UK and consequently there has been uncertainty in the management of dental patient presenting on these medications.

Appropriate for use throughout the UK, guidance has been produced by the Scottish Dental Clinical Effectiveness Programme (SDCEP) to clarify the current recommendations and expert advice for the newer oral anticoagulants and antiplatelet drugs.

Published in August 2015, the guidance is aimed primarily at dentists, hygienists and therapists in primary care dental practice but will also be of relevance to the secondary care dental service, those involved in dental education and undergraduate trainees. A number of supporting tools are included with the full guidance to assist the dental team to implement the guidance recommendations. These include patient information leaflets and post-treatment advice.