Anticoagulants and antiplatelets
Assess procedure bleeding risk, drug, indication and local haemostatic options using current guidance. Avoid unplanned cessation of therapy.
Understand
Bleeding risk reflects procedure, drug and patient factors; thromboembolic risk may be substantial if therapy is interrupted. Different agents and combinations require different planning.
Assess
Identify the medicine, dose schedule, indication, renal function where relevant, prior bleeding and the procedure's invasiveness. Plan local haemostasis and access to review.
Apply
Use current SDCEP guidance and liaise with the prescriber for exceptional situations. Avoid blanket advice to stop anticoagulants or antiplatelets; document the shared plan and postoperative instructions.
Key distinctions
The management question is not simply “is there a blood thinner?” but which drug, why, at what dose, when last taken and what intervention is planned. Local haemostasis can often control dental bleeding, whereas an interruption may cause stroke or thrombosis. Drug interactions with dental medicines matter too. Current SDCEP advice and prescriber discussion guide exceptions.
Think through a case
A person taking a DOAC needs a minor dental procedure. Drug timing, bleeding risk and local haemostasis are considered under current guidance rather than an automatic interruption.
The distinction to remember
Do not stop antithrombotic therapy without balancing stroke or thrombosis risk, especially in a patient with a recent event.
Test your recall
Why not tell every patient to stop anticoagulation?
Show answer
Thrombotic harm may outweigh manageable dental bleeding risk.