Precautions in patients under anticoagulant treatment

Anticoagulants are medicines used to prevent blood clots, also known as thromboses.

These medicines are prescribed to patients with an increased risk of developing blood clots, such as those with atrial fibrillation, heart valve disease or a history of thrombosis.

However, treatment with anticoagulants can be difficult as these drugs can increase the risk of bleeding.

It is therefore important to take precautions to reduce the risk of complications.

Here are some important precautions to be taken by patients taking anticoagulants:

Always consult with your doctor before taking any new medication or supplement, including herbal products. Some medications may interact with anticoagulants and increase the risk of bleeding.

Avoid activities that may cause injury, such as playing extreme sports or using dangerous tools at work.

Tell your doctor about any signs of bleeding, such as frequent nosebleeds or the appearance of red or purple spots on your skin.

Do not stop taking anticoagulants without first talking to your doctor. Stopping treatment suddenly may cause blood clots.

Make sure you have a sufficient supply of your medication so you don’t risk running out if the pharmacy runs out.

Talk to your doctor about a program to monitor your blood clotting levels. You may need to have regular tests to check your blood anticoagulant levels and to see if your dose needs adjusting.

Have regular medical check-ups to check that your anticoagulant treatment is effective and that there are no unexpected side effects.

Inform your medical staff about your anticoagulant treatment when you are scheduled for any medical or surgical procedure. This is important because some doctors may need to adjust anticoagulant treatment before the procedure.

Talk to your doctor about alternatives to anticoagulant treatment, if appropriate. In some situations, there are safe and effective alternatives to anticoagulants.

Anticoagulants and antiplatelet agents are medicines prescribed by your cardiologist to patients who are at high risk of developing a blood clot that may impede the physiological flow of blood.

These are patients suffering from cardiac arrhythmias, atrial fibrillation, pulmonary embolism or deep vein thrombosis.

As a side effect of anticoagulant administration we have prolonged bleeding and a predisposition to develop hematomas.

Without this anticoagulant treatment, patients are at risk of developing blood clots, followed by the formation of thrombi, formations that block the vessel lumen.

In the event that it detaches from the vessel lumen, the thrombus becomes a circulating embolus and can lead to myocardial infarction.

In dentistry we need to achieve homeostasis, i.e. a reduction of bleeding during invasive maneuvers.

Therefore, some dental treatments may require discontinuation of anticoagulants.

However, the risks and rewards of this decision must always be weighed up. It is the patient’s duty to inform the dentist about the prescription of anticoagulant medication and to provide the contact details of the current cardiologist.

Together, the dentist and cardiologist will choose the optimal solution for changing anticoagulant treatment.

Dental treatments with a high risk of bleeding

– Complex dental extractions – whether it’s several dental units that need to be extracted, wisdom molars included, or root remnants that also require milling of the alveolar bone, dental extractions can result in massive, hard-to-control bleeding.

– Periodontal surgery – periodontal procedures that involve the gingiva and alveolar bone and require the creation of flaps are associated with prolonged bleeding.

– Pre-prosthetic surgery – means the shaping of alveolar ridges for the application of dentures to provide an improved supporting surface.

– Coronal elongation – involves cutting 1-2mm of the gingival margin. The gingiva is a fibro mucous covering the alveolar processes of the teeth. The pink color that characterizes the gums is due to the numerous blood vessels that run through it.

– Dental implants – to place an implant means to drill through the cortex of the bone to insert a device to replace the lost root of the teeth. Obviously, perforating the mucosa leads to increased bleeding.

– Biopsies – if suspected malignant formations are detected, samples are taken from the oral cavity to be sent to specialist analysis.

Cutting of oral tissue also causes increased bleeding.

To reduce the risks during dental operations, there is a parameter that indicates the extent to which clotting is affected in patients undergoing treatment.

This index is called INR and normally, if the patient is not on anticoagulation, it is 1. The INR desired by the cardiologist is about 4 and the maximum value at which the dentist can perform the maneuvers is 2.2.

There is an increasing range of anticoagulant drugs and more and more cases of people being on treatment, so patients should inform their dentist about their current medication as well as associated diseases.

In general, taking simple precautions can help patients maintain their health and avoid complications while taking anticoagulants.

It is important to always consult your doctor and follow their advice to be sure that treatment is safe and effective.

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