Effects of Direct Oral Anticoagulants on Quality of Life during Peri-procedural Management for Dental Extractions

Publication date: Available online 12 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Fatih Cabbar, Ayça Turer Cabbar, Kahraman Cosansu, Elif Ijlal Cekirdekci

Abstract

Purpose

Direct oral anticoagulants (DOACs) have many advantages over warfarin regarding the peri-procedural management for dental extractions. They avoid the need to assess and possibly adjust warfarin therapy to achieve an appropriate hemostatic status before and after extraction. This study aimed to evaluate the real-life data regarding quality of life (QoL) and burden for patients with atrial fibrillation receiving long-term treatment with warfarin or DOACs during peri-procedural management for dental extraction.

Methods

The investigators implemented a multi-center study. The sample was composed of 205 patients who were using long-term anticoagulation treatment with warfarin (n=133) or DOACs (n=72). The Duke Anticoagulation Satisfaction Scale (DASS) was used to assess the QoL. Peri-procedural management for dental extraction was recorded using the questions designed by the investigators.

Results

Warfarin created a significantly greater burden for patients during peri-procedural management for dental extraction than did using DOACs. The DASS results showed that the QoL of patients was significantly better for the DOAC group than for the warfarin group (75.19±18.52 and 90.12±17.28, respectively; P=0.0001). Forty-five patients in the DOAC group who used warfarin as their previous therapy also underwent another tooth extraction while using warfarin. Of these patients, 91.1% picked DOACs as an anticoagulant of choice in terms of dental extraction.

Conclusion

The present findings suggest that DOACs had many advantages over warfarin regarding the reported QoL and peri-procedural management of dental extraction.

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