Guidance on management of dental patients taking anticoagulants or antiplatelet drugs

SDCEP-Anticoagulants & antiplatelets

The Scottish Dental Clinical Effectiveness Programme (SDCEP) has just launched its latest guidance on the Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs. The aim of the document is to clarify the current recommendations and expert advice for the newer oral anticoagulants and antiplatelet drugs and presents these, along with up-to-date recommendations for the more established medications, within a single widely available information resource.

The guidance was developed by a multidisciplinary guidance development group including medical and dental practitioners and specialists and a patient representative. Development of the recommendations followed the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach.

A number of guidance resources have been produced by the group; a full guidance document, quick reference guide and supporting tools. The full guidance document contains sections on:-

  • Anticoagulant and antiplatelet drugs
  • Assessing bleeding risk
  • Managing bleeding risk
  • Treating a patient taking warfarin or another vitamin K antagonist
  • Treating a patient on antiplatelet drug(s)
  • Treating a patient taking a novel oral anticoagulant (NOACs)
  • Treating a patient taking an injectable anticoagulant
  • Drug interactions between anticoagulants or antiplatelet drugs and other medications.

The quick reference guide includes a management flow chart with links to the relevant sections of the full guidance document. The supporting tools consist of a range of patient information letters and post treatment advice sheets


The risk of bleeding complications for those dental patients taking anticoagulants or antiplatelet medication is of concern. Warfarin and the antiplatelet agents aspirin and clopidogrel have been in use for many years and have well-established guidance in place. However the increasing use of newer anticoagulants such as apixaban, dabigatran and rivaroxaban and antiplatelet drugs, prasugrel and ticagrelor means that advice on the management of these patients is welcome.

As with other guidance documents from SDCEP a well structured approach has been taken to the development of these guidelines using the GRADE approach. The layout of the documents is clear with actions and key recommendations being clearly highlighted in the text. The patient information leaflets available for each category of drug will also be very helpful. For those working in Scotland there will also be two educational events in October to support the publication.


SDCEP- Management of Dental Patients Taking Anticoagulants or Antiplatelet drugs

Share on Facebook Tweet this on Twitter Share on LinkedIn Share on Google+
Mark as read
Create a personal elf note about this blog
Profile photo of Derek Richards

Derek Richards

Derek Richards is a specialist in dental public health, Director of the Centre for Evidence-Based Dentistry and Specialist Advisor to the Scottish Dental Clinical Effectiveness Programme (SDCEP) Development Team. A former editor of the Evidence-Based Dentistry Journal and chief blogger for the Dental Elf website until December 2023. Derek has been involved with a wide range of evidence-based initiatives both nationally and internationally since 1994. Derek retired from the NHS in 2019 remaining as a part-time senior lecturer at Dundee Dental School until the end of 2023.

More posts - Website

Follow me here –