J Korean Assoc Oral Maxillofac Surg.  2024 Aug;50(4):189-196. 10.5125/jkaoms.2024.50.4.189.

Post-extraction bleeding in patients on direct oral anticoagulants

• Kim MJ
• Kim MK
• Kang SH

• KMID: 2559265
• DOI: http://doi.org/10.5125/jkaoms.2024.50.4.189

Abstract

Objectives
This study aimed to evaluate the association between use of direct oral anticoagulants (DOACs) and post-extraction bleeding and to quantify bleeding risk in patients receiving DOACs.
Materials and Methods
The study included 293 patients who were taking DOACs and underwent tooth extraction (414 teeth). The patients were divided into those who had the extraction while taking DOACs and those who discontinued DOACs before the extraction. Bleeding complications were recorded and compared between the patient groups and types of DOACs.
Results
Of the 293 patients, 12 patients (6.9%) had post-extraction bleeding. Post-extraction bleeding occurred in 12 of the 414 tooth extraction sites. Among the 246 patients who underwent dental extraction while continuing DOAC therapy, 12 patients (8.5%) had post-extraction bleeding. Among the 47 patients who underwent dental extraction after discontinuing the administration of DOACs, none reported post-extraction bleeding. There was no significant difference in the number of patients with post-extraction bleeding between the two groups (P=0.122).
Conclusion
Continuing DOAC therapy during dental extraction does not increase post-extraction bleeding tendency. These results are consistent with those of previous studies.

Keyword

Postoperative hemorrhage; Tooth extraction; Antithrombins; Factor Xa inhibitors; Anticoagulants