DOAC Management for Dental Surgery — NDEB AFK MCQ

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ModeratePharmacologyDOAC Management for Dental SurgeryNDEB AFK

A patient on a direct oral anticoagulant (DOAC) such as rivaroxaban requires a surgical extraction. What is the recommended approach?

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Correct answer: E — Continue the DOAC and use local haemostatic measures

For routine dental extractions in patients on DOACs (rivaroxaban, apixaban, dabigatran, edoxaban), current guidelines recommend continuing the medication and using local haemostatic measures (sutures, oxidised cellulose, tranexamic acid rinse, gelatin sponge). The short half-life of DOACs (5-17 hours) and the low bleeding risk of dental surgery make interruption unnecessary for most procedures. Timing the appointment to coincide with the trough level (just before the next dose) may further reduce bleeding risk.

Reference: SDCEP – Management of Dental Patients Taking Anticoagulants or Antiplatelets, 2022