Effects of Direct Oral Anticoagulants on Quality of Life During Periprocedural Management for Dental Extractions.


Assistant Professor and Chief Medical Director, Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Yeditepe University, Istanbul, Turkey. Electronic address: [Email]


OBJECTIVE : Direct oral anticoagulants (DOACs) have many advantages over warfarin regarding periprocedural management for dental extractions. They avoid the need to assess and possibly adjust warfarin therapy to achieve appropriate hemostatic status before and after extraction. The present study evaluated 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 periprocedural management for dental extraction.
METHODS : We implemented a multicenter study. The sample was composed of 205 patients who had been receiving long-term anticoagulation treatment with warfarin (n = 133) or DOACs (n = 72). The Duke Anticoagulation Satisfaction Scale (DASS) was used to assess the QoL. Periprocedural management for dental extraction was recorded using the questions designed by us.
RESULTS : Warfarin created a significantly greater burden for patients during periprocedural management for dental extraction compared with DOACs. The DASS results showed that the QoL of patients was significantly better for the DOAC group than for the warfarin group (score, 75.19 ± 18.52 and 90.12 ± 17.28, respectively; P = .0001). Of the patients in the DOAC group, 45 had used warfarin as their previous therapy and had undergone another tooth extraction while using warfarin. Of these patients, 91.1% chose DOACs as their anticoagulant of choice for dental extraction.
CONCLUSIONS : The present findings suggest that DOACs have many advantages compared with warfarin regarding the reported QoL and periprocedural management of dental extraction.

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