Tranexamic Acid Mouthwash — MFDS Part 1 MCQ
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Correct answer: D — Reduce post-extraction bleeding by inhibiting local fibrinolysis
Tranexamic acid mouthwash is an adjunctive local haemostatic measure. It inhibits conversion of plasminogen to plasmin and therefore reduces fibrin clot breakdown at the extraction site. It does not reverse warfarin or directly activate platelets. It is neither an antimicrobial treatment for alveolar osteitis nor an analgesic acting through prostaglandin inhibition. Under SDCEP guidance, packing, suturing and gauze compression remain the standard local measures. Tranexamic acid mouthwash is prepared off-label, and SDCEP does not advise its routine prescription by primary care dental practitioners; if it has been prescribed by the patient's medical practitioner, it should be used in addition to—not instead of—local haemostatic measures.
Reference: Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd edition, section 4.1: Haemostatic Measures. 2022. https://www.sdcep.org.uk/media/ypnl2cpz/sdcep-management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs-2nd-edition.pdf