Cardiovascular conditions, apart from neoplastic diseases, remain the major cause of death in developed countries; therefore, the number of patients receiving oral
anticoagulants is constantly increasing.
Anticoagulant therapy considerably reduced mortality in patients with history of
myocardial infarction among others. Although many interventions may be performed without withdrawal of the
anticoagulant and
tooth extraction was qualified as a procedure of low
hemorrhage risk, a majority of dentists refer the patient to a cardiologist several days before the elective
tooth extraction to withdraw
anticoagulants. The aim of the study was to evaluate the efficacy and safety of
bone wax used to stop
bleeding after dental procedures in a group of patients on chronic
anticoagulant therapy and find an answer to a question, whether it is justified to temporarily withdraw
anticoagulants for this type of procedures. The study involved 176 patients on chronic
anticoagulant therapy undergoing
tooth extraction (154 subjects) or surgical extraction of a retained tooth (48 subjects). After the procedure, in each case the alveolus was filled with
bone wax to stop
bleeding. In all patients involved in the study
bleeding from the alveolus was successfully stopped during the procedure. None of the subjects reported increased
bleeding from the operational site after coming back home.
Bone wax is a good, efficient, and safe material to block
bleeding from the alveolus following
tooth extractions, also in patients on chronic
anticoagulant therapy. The study demonstrated that withdrawal or adjustment of
anticoagulant therapy is not necessary before an elective
tooth extraction.