What do they know? Evaluation of patient and clinician management of direct oral anti-coagulant and antiplatelets therapy prior to dental extractions.

Introduction Managing dental extractions in patients prescribed anticoagulant or antiplatelet medications poses challenges due to the risk of post-operative bleeding. Direct oral anticoagulants (DOACs) are increasingly prescribed, yet variations in patient understanding and clinician adherence to guidelines is unexplored.Aims To evaluate clinician and patient management of DOAC and antiplatelet medications during dental extractions, assess patient understanding, and explore post-operative outcomes.Materials and methods A three-month prospective service evaluation at Liverpool University Dental Hospital assessed 26 patients on anticoagulant/antiplatelet therapy. Data collated included patient demographics, DOAC/antiplatelet medication, treatment plan, and clinician advice regarding DOAC/antiplatelet management. Patients completed questionnaires on medication understanding and were contacted on days one and five post-extraction to report complications.Results Twenty-four patients underwent extractions, with most requiring three or fewer routine extractions. Six patients lacked initial information about their medication, and only eleven were aware of its bleeding risks. Three patients altered their medication regimen against clinician advice. Four patients experienced minor bleeding on day one which was self-managed. No patients reported bleeding beyond day one.Discussion Findings highlight gaps in patient education regarding their DOAC/antiplatelet medication and the need for improved, multimodal information delivery. Local haemostatic measures were effective in minimising complications.Conclusion Enhanced patient education, adherence to guidelines, and robust documentation can improve outcomes and minimise risks in dental procedures for this patient group.