10/04/2025
Treatment planning for anticoagulated patients requires close interdisciplinary collaboration with the treating primary care physicians and/or internists.13,17 In this regard, it is important that the dentist is aware of their role as a specialist for the oral cavity and assesses the risk of bleeding during surgical procedures. There is now extensive literature on the subject of dental procedures in permanently anticoagulated patients, concluding that the anticoagulation regimen should be maintained and dental surgery performed. In this context, reference should be made to the S3 guideline of the DGZMK and the statement of the American Dental Association (ADA). For many internal medicine colleagues, the term surgical intervention automatically leads to patients being switched in their anticoagulant regimen (bridging), as may often be indicated for major surgical interventions. This bridging affects patients who are adjusted with vitamin K antagonists. It is precisely here that the dentist must inform his colleagues in internal medicine about the expected risk of bleeding and, with a few exceptions, advise them to maintain continuous anticoagulation. If the patient‘s medication is not changed, the treatment process is significantly simplified for all involved and the patient is not exposed to any increased risks. Yet because of the complexity of coagulation and the underlying diseases that require anticoagulation, the dentist in the practice should not change anything about the coagulation situation and the medication regimen followed by the patient.
