Unfamiliar Anticoagulant Approach — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementUnfamiliar Anticoagulant ApproachORE Part 1

A patient requires a dental extraction and reports taking betrixaban. The dentist cannot confirm an evidence-based dental peri-operative regimen for this medicine from current local guidance. What is the most appropriate action?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: A — Seek advice from the prescribing clinician before treatment

Explanation lettering: E = shown as C · C = shown as D · D = shown as E

The correct answer is A. SDCEP gives DOAC-specific dental advice for apixaban, dabigatran, rivaroxaban and edoxaban; it does not provide a betrixaban regimen. Where the medicine is outside the applicable guidance, the dentist should confirm management with the prescriber or relevant specialist before an invasive procedure. B is unsafe because DOAC dosing, pharmacokinetics and interruption advice are drug-specific. C is unjustified and could expose the patient to avoidable thromboembolic risk. D is incorrect: vitamin K reverses vitamin K antagonists such as warfarin, not factor Xa inhibitors. E is inappropriate because changing long-term anticoagulation is a prescribing-specialist decision, not a dental intervention.

Reference: Scottish Dental Clinical Effectiveness Programme. Dental Companion: Direct oral anticoagulants (DOACs) – Recommendations, 2022. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/direct-oral-anticoagulants-doacs/recommendations/