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Warfarin and Dental Extraction — NDEB AFK MCQ

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ModerateOral SurgeryWarfarin and Dental ExtractionNDEB AFK

A patient on warfarin with an INR of 2.8 requires extraction of a single-rooted tooth. According to current Canadian guidelines, what is the most appropriate management?

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

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Correct answer: D — Continue warfarin and use local haemostatic measures

Current guidelines recommend that patients on stable warfarin therapy with an INR in the therapeutic range (typically ≤3.5 for routine dental extractions, and certainly ≤3.0 for simple extractions) should continue their anticoagulant and local haemostatic measures (oxidised cellulose, sutures, tranexamic acid mouthwash) should be used. Stopping warfarin increases thromboembolic risk (stroke, DVT, PE) which outweighs the bleeding risk from dental extractions.

Reference: CDA – Dental Management of Patients on Anticoagulants, 2018; Lockhart PB et al – JADA, 2003