Biomaterial Database

An evidence summary of the management of patients taking direct oral anticoagulants (DOACs) undergoing dental surgery. 2016

S Johnston

Balfour Oral Surgery Unit, NHS Orkney, Balfour Hospital, Kirkwall, Orkney, Scotland, UK. Electronic address: steven.johnston@nhs.net.

Direct oral anticoagulant (DOAC) drugs (dabigatran, rivaroxaban, and apixaban) have emerged in the last decade to overcome some of the drawbacks of existing medications. To date, little is known about the dental management of patients taking these drugs. This study was undertaken to establish the evidence for the management of patients undergoing dental procedures while taking these medications. A rapid review approach was used to identify clinical and scientific research related to dental surgery performed in patients taking DOACs in order to produce an evidence summary. The rapid review did not identify any systematic reviews or original clinical trials and the overall quality of evidence found was poor. Most of the literature consisted of non-structured review articles and guidance documents based on assumptions from non-dental data and expert opinion, and recommendations on best practice varied throughout. The findings from the review of the literature varied considerably. Currently, recommendations are based on poor quality scientific data and clinical trials are required to establish best evidence-based practice guidance.

UI	MeSH Term	Description	Entries
D011720	Pyrazoles	Azoles of two nitrogens at the 1,2 positions, next to each other, in contrast with IMIDAZOLES in which they are at the 1,3 positions.
D011728	Pyridones	Pyridine derivatives with one or more keto groups on the ring.	Pyridinones
D006801	Humans	Members of the species Homo sapiens.	Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000069552	Rivaroxaban	A morpholine and thiophene derivative that functions as a FACTOR XA INHIBITOR and is used in the treatment and prevention of DEEP-VEIN THROMBOSIS and PULMONARY EMBOLISM. It is also used for the prevention of STROKE and systemic embolization in patients with non-valvular ATRIAL FIBRILLATION, and for the prevention of atherothrombotic events in patients after an ACUTE CORONARY SYNDROME.	5-chloro-N-(((5S)-2-oxo-3-(4-(3-oxomorpholin-4-yl)phenyl)-1,3-oxazolidin-5-yl)methyl)thiophene-2-carboxamide,BAY 59-7939,Xarelto,BAY 59 7939,BAY 597939
D000069604	Dabigatran	A THROMBIN inhibitor which acts by binding and blocking thrombogenic activity and the prevention of thrombus formation. It is used to reduce the risk of stroke and systemic EMBOLISM in patients with nonvalvular atrial fibrillation.	BIBR 1048,Dabigatran Etexilate,Dabigatran Etexilate Mesylate,N-((2-(((4-(aminoiminomethyl)phenyl)amino)methyl)-1-methyl-1H-benzimidazol-5-yl)carbonyl)-N-2-pyridinyl-beta-alanine,Pradaxa,Etexilate Mesylate, Dabigatran,Etexilate, Dabigatran,Mesylate, Dabigatran Etexilate
D000284	Administration, Oral	The giving of drugs, chemicals, or other substances by mouth.	Drug Administration, Oral,Administration, Oral Drug,Oral Administration,Oral Drug Administration,Administrations, Oral,Administrations, Oral Drug,Drug Administrations, Oral,Oral Administrations,Oral Drug Administrations
D000991	Antithrombins	Endogenous factors and drugs that directly inhibit the action of THROMBIN, usually by blocking its enzymatic activity. They are distinguished from INDIRECT THROMBIN INHIBITORS, such as HEPARIN, which act by enhancing the inhibitory effects of antithrombins.	Antithrombin,Direct Antithrombin,Direct Antithrombins,Direct Thrombin Inhibitor,Direct Thrombin Inhibitors,Antithrombin, Direct,Antithrombins, Direct,Inhibitor, Direct Thrombin,Thrombin Inhibitor, Direct,Thrombin Inhibitors, Direct
D019647	Oral Surgical Procedures	Surgical procedures used to treat disease, injuries, and defects of the oral and maxillofacial region.	Maxillofacial Procedures,Oral Surgical Procedure,Procedure, Oral Surgical,Procedures, Oral Surgical,Surgical Procedure, Oral,Surgical Procedures, Oral,Maxillofacial Procedure,Procedure, Maxillofacial,Procedures, Maxillofacial
D065427	Factor Xa Inhibitors	Endogenous factors and drugs that inhibit or block the activity of FACTOR XA.	Direct Factor Xa Inhibitor,Direct-Acting Oral Anticoagulant,Direct-Acting Oral Anticoagulants,Factor Xa Inhibitor,Direct Factor Xa Inhibitors,Anticoagulant, Direct-Acting Oral,Anticoagulants, Direct-Acting Oral,Direct Acting Oral Anticoagulant,Direct Acting Oral Anticoagulants,Inhibitor, Factor Xa,Oral Anticoagulant, Direct-Acting,Oral Anticoagulants, Direct-Acting,Xa Inhibitor, Factor