Warfarin Periodontal Treatment — ORE Part 1 MCQ
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Correct answer: C — Proceed without interrupting warfarin; use local haemostatic measures.
Explanation lettering: E = shown as A · A = shown as C · C = shown as D · D = shown as E
The correct answer is A. SDCEP advises that a patient taking warfarin with an INR below 4 should receive dental treatment without interruption of anticoagulation. An INR of 2.5 therefore permits subgingival scaling and root surface debridement, provided bleeding-risk precautions are used. The INR should be checked ideally within 24 hours of treatment; a result within 72 hours is acceptable only where the INR is stable. For root surface debridement, consider limiting the initial area, for example to three teeth, and use local haemostatic measures. B and E unnecessarily interrupt or discontinue warfarin, increasing thromboembolic risk. C requires a subtherapeutic INR and is unsupported. D is unnecessary solely because of warfarin use when the INR is below 4.
Reference: Scottish Dental Clinical Effectiveness Programme, Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, Second Edition (2022), section: Warfarin or another Vitamin K antagonist. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/warfarin-or-another-vitamin-k-antagonist/