Oral Anticoagulants and Dental Procedures (AGD 010)
Presenter: Ashley N. Castelvecchi, PharmD & Lamonica N. Crump, PharmD
Anticoagulants and antiplatelets are commonly used for various conditions including the treatment and prevention of cardiac disease, cerebral vascular accident, and thromboembolism, in both the inpatient and outpatient settings. As such, dental professionals will encounter many patients taking these medications. For these patients, several factors should be considered prior to a dental procedure; the indication for anticoagulant or antiplatelet therapy, bleeding risk, and thromboembolic risk must be assessed prior to interruption of therapy. Evaluating the risk versus benefit of continuing therapy can assist in determining if and when it is appropriate to interrupt therapy. Additionally, patients receiving anticoagulant and antiplatelet medications are frequently managed by different healthcare providers and specialists, so it is important to maintain open communication and inform other providers if alteration of therapy is warranted, and provide clear instructions and education to both the patient and caregivers.
The management of anticoagulant and antiplatelet therapy prior to dental procedures can be complex due to the potential to prolong bleeding times, however recent studies and guidelines suggest that these medications can be safely continued for most minor dental procedures.1-5 Dental professionals should still be prepared to use local measures to manage any excessive bleeding. This course will discuss the available oral anticoagulant and antiplatelet therapies available in the United States as well as the recommended management of these agents prior to dental procedures.
Ashley N. Castelvecchi, PharmD, BCGP is a Clinical Pharmacy Specialist for the Home-Based Primary Care program at the Veterans Affairs Outpatient Clinic in Greenville, South Carolina. She has a Doctor of Pharmacy from the University of Kentucky and completed a Post-Graduate Year One Clinical Pharmacy Residency at the Veterans Affairs Medical Center in Lexington, Kentucky.
Lamonica N. Crump, PharmD is a Clinical Pharmacy Specialist at the Veterans Affairs Outpatient Clinic in Greenville, South Carolina. She has a Bachelors of Science and a Doctor of Pharmacy from the University of South Carolina.
Upon completion of this course, the dental professional should be able to:
• describe the different types of oral anticoagulants and antiplatelets and the mechanisms of action.
• evaluate the risks associated with interruption of anticoagulant and antiplatelet medications prior to dental procedures.
• identify strategies to manage bleeding risk reduction following dental procedures.
• outline the role of health care professionals in the management of oral health care.
CONTINUING EDUCATION CREDITS
The ADAA has an obligation to disseminate knowledge in the field of dentistry. Sponsorship of a continuing education program by the ADAA does not necessarily imply endorsement of a particular philosophy, product or technique.
The ADAA cautions participants taking this course on the hazards of using limited knowledge when integrating new techniques into their practices.
Credits earned upon completion of the course may be used to meet DANB’s Recertification Requirements.
CONCERNS OR HELP
If the participant has concerns about the presentation, please contact our Education Department at CESupport@adaausa.org. If the participant has questions on how to view the presentation, please contact Tech Support at TechSupport@adaausa.org.
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