72-Hour INR Acceptable — ORE Part 1 MCQ

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EasyHuman Disease & Dental Management72-Hour INR AcceptableORE Part 1

A patient taking warfarin requires dental treatment likely to cause bleeding. Their INR was measured 72 hours ago and was 3.0. They have not required weekly INR monitoring and have had no recent INR result above 4. Is this INR result acceptable for proceeding?

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Correct answer: D — Yes; it is within the permitted interval for a stable INR

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

Answer: A. SDCEP advises that INR should ideally be checked within 24 hours before dental treatment likely to cause bleeding. However, an INR result obtained up to 72 hours beforehand is acceptable for a stable patient. Stability is consistent with not requiring weekly monitoring and having no INR result above 4 in the preceding two months. This patient meets those criteria, and the INR of 3.0 is below 4, so treatment can proceed without interrupting warfarin. Options B and C impose unnecessarily restrictive timings not required by SDCEP. Option D is incorrect because the guidance requires a valid INR result, not testing by the dental team. Option E wrongly uses duration of warfarin therapy rather than INR stability.

Reference: Scottish Dental Clinical Effectiveness Programme. SDCEP Dental Companion: Warfarin or another Vitamin K antagonist, Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd edition, 2022. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/warfarin-or-another-vitamin-k-antagonist/