General dentists' approach to dental management of patients taking anticoagulants: a national survey-based assessment: pre- and post-procedure practice

Authors

• Sharon Elad
• Rebekah Boy
• Michael C. Leo
• Greg C. Connolly, Rochester Regional HealthFollow
• Rita Cacciato
• Jin Xiao
• Suzanne Gillespie
• Denis B. Nyongesa
• Gregg H. Gilbert
• Cyril Meyerowitz

Department

Oncology and Hematology

Document Type

Article

Publication Title

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology

Abstract

Aim: To determine the pre-operative and post-operative practices of general dentists (GDs) in the community for patients taking vitamin K antagonists (VKA) and direct oral anti-coagulants (DOACs).

Methods: An online questionnaire was administered to GD members of the National Dental Practice-Based Research Network. GDs were queried about the interaction with the medical professional prior to dental treatment, use of laboratory tests to assess bleeding risk, measures to control bleeding, and comfort level with delivering dental care.

Results: A total of 47.6% and 41.2% of GDs "always" consult with the patient's physician prior to an extraction in a patient on VKA or DOACs, respectively. 27.1% and 8.7% of GDs use laboratory tests to assess risk for bleeding prior to a dental extraction in patients on VKA and DOAC, respectively. For VKA patients, GDs prefer INR testing (68.4%), and for DOAC patients, most GDs are "unsure" what blood test to use. The most-used hemostatic agents were cellulose (65.1%), collagen (60.6%) and epinephrine infiltration (60.6%).

Conclusions: GDs are uncertain about the best approach for patients taking DOACs. INR is not routinely used by most GDs to assess the bleeding risk in patients taking VKA. The most commonly used hemostatic agents are cellulose-based, collagen-based and vasoconstrictors.

First Page

592

Last Page

601

DOI

10.1016/j.oooo.2026.04.006

Volume

142

Issue

4

Publication Date

10-1-2026

Medical Subject Headings

Humans; Anticoagulants; Practice Patterns, Dentists'; Surveys and Questionnaires; United States; General Practice, Dental; Dental Care for Chronically Ill; Female; Preoperative Care; Vitamin K; Postoperative Care; Risk Assessment

PubMed ID

42315384

Recommended Citation

Elad, S., Boy, R., Leo, M. C., Connolly, G. C., Cacciato, R., Xiao, J., Gillespie, S., Nyongesa, D. B., Gilbert, G. H., & Meyerowitz, C. (2026). General dentists' approach to dental management of patients taking anticoagulants: a national survey-based assessment: pre- and post-procedure practice. Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 142 (4), 592-601. https://doi.org/10.1016/j.oooo.2026.04.006