Warfarin Management — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementWarfarin ManagementORE Part 1

A patient taking warfarin requires a routine dental extraction. Their anticoagulation has been stable, and an INR measured 72 hours before the procedure is 2.8. What is the most appropriate management of warfarin?

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Reveal the answer and explanation

Correct answer: E — Continue warfarin without interruption

Explanation lettering: E = shown as A · A = shown as E

The correct answer is A. SDCEP advises that a patient taking warfarin with an INR below 4 should undergo dental treatment without interruption of anticoagulant therapy. Although INR should ideally be checked within 24 hours, a result obtained up to 72 hours beforehand is acceptable when anticoagulation is stable; this patient meets both requirements. The extraction should be planned with appropriate local haemostatic measures, such as packing and suturing where indicated. Options B–E are inappropriate because withholding warfarin is not routinely required for a dental extraction at INR 2.8 and exposes the patient to avoidable thromboembolic risk. If the INR were 4 or above, invasive treatment should be delayed and the anticoagulation service or GP contacted.

Reference: Scottish Dental Clinical Effectiveness Programme. Dental Companion: Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, “Warfarin or another Vitamin K antagonist” (2022 guidance; accessed 2026). https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/warfarin-or-another-vitamin-k-antagonist/