UC Davis

Newer oral anticoagulants (NOAs) such as dabigatran etexilate, rivaroxaban, edoxaban, and apixaban are widely used these days as an alternative to warfarin for anticoagulation. Surgical procedures such as extraction are common during dental treatments and are often associated with bleeding. Hence, when treating patients taking anticoagulants clinicians must have a thorough knowledge of the pharmacology of these drugs for adequate management and prevention of any complications to their patients. Clinicians need to constantly update their knowledge as the NOA drugs have been newly introduced and studies regarding their use during dental procedures are only recently available in the literature and continue to evolve. The objective of this paper is to assist clinicians in providing dental care for patients taking these newer oral anticoagulants and are at risk of bleeding complications during dental procedures. In order to accomplish this, a Clinical Decision Support (CDS) system can be developed to allow clinicians to rely on, for any information on these drugs. Clinical decision rules and recommendations are provided to the clinicians in light of the most recently available knowledge.