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Warfarin and dental extraction — NDEB AFK MCQ

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HardBiomedical SciencesWarfarin and dental extractionNDEB AFK

A 76-year-old taking warfarin for atrial fibrillation needs extraction of tooth 2.6. The INR measured the previous day is 2.4, blood pressure is controlled, and there is no liver disease. What is the most appropriate treatment?

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

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Correct answer: B — Proceed with local haemostatic measures

For many simple dental extractions, a therapeutic INR such as 2.4 can be managed with local haemostasis rather than interrupting anticoagulation. Stopping warfarin exposes the patient to thromboembolic risk and is not justified by these data. The pearl is to confirm a recent INR and use sutures, pressure, and tranexamic acid where appropriate.

Reference: Canadian dental pharmacology references; NDEB KSAs 2024