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Year : 2017  |  Volume : 6  |  Issue : 1  |  Page : 1-4

Management of patients taking rivaroxaban for dental treatments

Department of Surgery, Faculty of Medicine, University of Salamanca, Salamanca, Spain

Correspondence Address:
Adrian Curto
Department of Surgery, Faculty of Medicine, University of Salamanca, Alfonso X El Sabio, s/n, 37007 Salamanca
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2278-9626.198585

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There are several novel anticoagulant drugs that are being increasingly used as an alternative to warfarin and acenocoumarol. Novel oral anticoagulants have emerged in recent years to overcome some of the drawbacks of classic oral anticoagulants. Rivaroxaban, dabigatran, apixaban, and edoxaban were approved by the Food and Drug Administration and European Medicines Agency. This paper examines the available evidence regarding rivaroxaban and sets out proposals for the clinical guidance of dental practitioners treating these patients in primary dental care. Literature search was conducted through May 2016 for publications in the ISI Web of Knowledge, PubMed, and Cochrane Library using the keywords, "rivaroxaban," "dabigatran," "apixaban," "edoxaban," "new oral anticoagulants," "novel oral anticoagulants," "bleeding," and "dental treatment." For patients requiring minor oral surgery procedures, interruption of rivaroxaban is not generally necessary while a higher control of bleeding and discontinuation of the drug (at least 24 h) should be requested before invasive surgical procedure, depending on renal functionality. Their increased use means that oral care clinicians should have a sound understanding of the mechanism of action, pharmacology, reversal strategies, and management of bleeding in patients taking rivaroxaban. Currently, recommendations are based on poor quality scientific data and clinical trials are required to establish best evidence-based practice guidance.

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