Risk of postoperative bleeding after dental procedures in patients on warfarin: a retrospective study

Objectives. The purpose of this retrospective study was to investigate the frequency of bleeding complications after invasive dental procedures in warfarinized patients and the possible risk factors. Study Design. The CoaguChek System was used to obtain an in-office international normalized ratio (INR) value for 122 patients (240 appointments), of which the mean age was 57.0 +/- 15.9 years and 50% were males. Demographic and clinical information were obtained retrospectively from dental and medical records. Results. Five episodes (mean INR: 2.0 +/- 0.8) of persistent bleeding were identified; 4 were after extractions and 1 was after implant placement. The frequency of bleeding was 4.8%, if only considering surgical procedures. Postoperative bleeding was significantly higher (P < .05) in patients who were taking anti-thrombotic medications in addition to warfarin. Conclusions. There is a low incidence of persistent bleeding after invasive dental procedures in warfarinized patients but the risk appears to increase with the use of concomitant anti-thrombotic medications. (Oral Surg Oral Med Oral Pathol Oral Radiol 2012;114:464-468)