Question 123 · LDEK · Medically compromised patient

Indicate the false statement concerning dental procedures in patients receiving oral anticoagulants (OACs):

1. AA. in patients subjected to invasive dental procedures of a small or medium bleeding risk, there is no need for stopping OACs therapy; the treatment can be performed with INR between 2.0 - 3.5, with its evaluation done on the day of the scheduled procedure or the day before.
2. BB. in patients qualified for massive invasive surgical procedures of a major bleeding risk which also pose a medium or high risk of thromboembolic events, the bridge therapy should be implemented.
3. CC. in patients qualified for massive invasive surgical procedures of major bleeding risk, OACs therapy can be discontinued if the patient belongs to the group of the low risk of thromboembolic events, in coordination with the treating physician: acenocoumarol should be discontinued for 5 days, and warfarin for 1 to 2 days before the planned surgery to decrease INR to less than 1,5.
4. DD. in the case of massive oral cavity sanitation in patients with a high bleeding risk, but belonging to the group of the low risk of thromboembolic events, the maximum safe OACs withdrawal period is 7 days.
5. EE. in the case of the necessity of a very fast anticoagulative drug action reversal, the transfusion of fresh frozen plasma is used.