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Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs

Published March 2022 (2nd Edition) 

Introductory video for the 2022 edition of the guidance:

Downloads 

  • Full Guidance (PDF)provides comprehensive background information, recommendations and practical advice.  
  • Quick Reference Guide (PDF) summarises the main recommendations and clinical practice advice from the full guidance using treatment planning flowcharts. 

App

Also available via the SDCEP Dental Companion app.

Supporting tools 

A number of supporting tools are included with the full guidance to help the dental team implement the guidance recommendations. These are available for download: 

  • Post-Treatment Advice for Dental Patients (PDF) – advice sheet to which individual post-treatment instructions and local emergency contact details can be added.  If providing to a patient digitally, save the document by printing to pdf after adding any specific instructions, to prevent further modification. 
  • Pre-Dental Treatment Instructions - DOACs (PDF) – fillable sheet for providing and recording individual pre-treatment instructions for dental patients taking a direct oral anticoagulant (DOAC).  If providing to a patient digitally, save the document by printing to pdf after adding patient details and specific instructions, to prevent further modification. 
  • Pre-Dental Treatment Instructions - Warfarin (PDF) – fillable sheet for providing and recording individual pre-treatment instructions for dental patients taking warfarin or another vitamin K antagonist.  If providing to a patient digitally, save the document by printing to pdf after adding patient details and specific instructions, to prevent further modification. 

About this guidance 

The second edition of Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs aims to provide clear and practical advice to enable the dental team to manage and treat this patient group. The guidance presents advice to inform the assessment of bleeding risk and decision making for treatment planning. Specific recommendations for managing dental treatment for patients taking the various types of medication, including direct oral anticoagulants, warfarin and other vitamin K antagonists, low molecular weight heparins and antiplatelet drugs, are provided.  

Advice points to support sustainable oral health are included as a result of consideration of the potential environmental impact of the recommendations and clinical advice in this guidance.  

While the guidance is aimed primarily at dental professionals, aspects of the guidance will also be of relevance to medical professionals including those who prescribe or dispense anticoagulants and antiplatelet drugs. 

NICE has accredited the process used by the Scottish Dental Clinical Effectiveness Programme to produce its Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs guidance. Accreditation is valid for 5 years from 15 March 2021. More information on accreditation can be viewed at www.nice.org.uk/accreditation.  Further information about NICE accreditation of SDCEP guidance can be viewed at NICE Accreditation

The College of General Dentistry and the dental faculties of the Royal Colleges have endorsed the second edition of this guidance as a source of reliable, high quality professional advice that promotes the provision of safe and effective oral health care for patients.  

Guidance development 

The second edition of this guidance is based on a full review of the content and current evidence, and the opinion of dental and medical experts, experienced practitioners and patients. The Guidance Development Group (GDG) for this guidance update comprised individuals from a range of branches of the dental and medical professions, including oral surgery, oral medicine, special care dentistry, restorative dentistry, general dental practice, dental therapy, cardiology, haematology, pharmacy, and general medical practice, and two patient representatives. Details of the GDG members are provided in the full guidance document. 

The updated guidance has been subject to external peer review prior to finalising for publication and SDCEP acknowledges the important contribution of all those who commented during this stage. 

The methodology used for the development of this guidance, including details of the evidence search strategy, evidence summaries, considered judgements and information about conflict of interests can be found in the Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs Guidance Methodology 2022 (PDF). Further information is available at the SDCEP guidance development process webpage, or by contacting the SDCEP office (scottishdental.cep@nes.scot.nhs.uk). 

During the development process, potential barriers to the implementation of this guidance were identified. A Guidance Implementation Summary (PDF) of information about these is provided. For further details visit the TRiaDS website. 

Review and updating 

For this guidance, a review of the topic will take place five years after publication and, if this has changed significantly, the guidance will be updated accordingly. 

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