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dental procedure

Complications: - invasive dental procedures are transiently at increased risk (4 weeks following procedure) for myocardial infarction (MI) or ischemic stroke [4] Management: 1) NOT necessary to stop warfarin for dental procedures, provdided INR in the therapeutic range [1,3] 2) NOT necessary to stop low-dose aspirin for dental procedures [2] 3) tranexamic acid (Cyklokapron) or aminocaproic acid (Amicar) may be diluted & used as mouthwash to help prevent bleeding a) rinse with 10-15 mL for 2 minutes then spit out b) rinse 30 minutes before procedure, then QID for 1 or 2 days c) avoid rinsing too hard as this may dislodge any clot that may have formed after the procedure 4) also see prophylaxis for bacterial endocarditis 5) antibiotic prophylaxis may also be required for dental procedures in patients with aortic prosthesis (endovascular graft) [5] - see prophylaxis for aortic prosthesis [5]

Related

antibiotic prophylaxis for bacterial endocarditis dentistry (oral health) prophylaxis for aortic prosthesis (endovascular graft)

General

oral surgery

References

  1. Prescriber's Letter 9(7):41 2002
  2. Prescriber's Letter 10(12):67-68 2003
  3. Prescriber's Letter 11(11): 2004 Management of Anticoagulation During Invasive Procedures Detail-Document#: 201105 (subscription needed) http://www.prescribersletter.com
  4. Minassian C et al Invasive dental treatment and risk for vascular events: a self-controlled case series. Ann Intern Med. 2010 Oct 19;153(8):499-506. PMID: 20956706
  5. Abdominal Aortic Aneurysm. Society for Vascular Surgery In: Anello J, Feinberg B, Heinegg J et al New Clinical Practice Guidelines, February 2018. Medscape. February 07, 2018 https://reference.medscape.com/viewarticle/892328 - Glovicki P, Lawrence PF, Forbes TL. Update of the Society for Vascular Surgery abdominal aortic aneurysm guidelines. J Vasc Surg. 2018 Jan;67(1):1. http://www.jvascsurg.org/article/S0741-5214(17)32369-8/fulltext