Anticoagulantes orales de acción directa y su relación con la práctica clínica odontológica

Résumé

Oral anticoagulants are used for the prevention and treatment of a broad spectrum of thromboembolic diseases. It is estimated that anticoagulated patients constitute 1-2% in the world population. Being a chronic treatment, the probability that they will undergo dental procedures throughout life is high. When this occurs, a dilemma arises: the interruption or not of anticoagulation taking into account the thromboembolic risk compared to the hemorrhagic risk associated with each of these two options. A bibliographic review has been carried out on this fact and on the dental performance that is proposed for this type of patients. The objective of this article is to show, with the available evidence, that the vast majority of interventional dental procedures can be performed safely for the patient, without suspending anticoagulant medication, and controlling bleeding with local measures. All this against the thromboembolic risk, possibly fatal, which means suspending this medication. On this basis, action guidelines for different clinical scenarios that may occur in daily practice are updated and proposed.