Oral anticoagulant therapy: Preventing bleeding in patients having dental extractions

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This Cochrane review of antifibrinolytic agents for preventing bleeding in people on oral anticoagulants undergoing dental extractions or minor oral surgery included 4 RCTs. Topical tranexamic acid was effective in reducing post-operative bleeding following dental procedures.

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Fixed appliance orthodontics: extraction or non-extraction and soft tissue changes

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52 studies were identified for this review of the effect of extraction or non-extraction fixed orthodontic treatment of soft tissue profiles . However they were mainly poor quality retrospective studies providing very low quality evidence suggesting that tooth extractions might be associated with differences in the soft tissue profile compared to non-extraction treatment.

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Bleeding after dental extraction: no evidence from randomised trials

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This update of a 2016 Cochrane Oral Health Group review of interventions for post extraction bleeding was unable to identify any published or ongoing trials assessing interventions. Well conducted and reported randomised controlled trials are needed on this question.

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Tranexamic acid for minor oral surgery in anticoagulated patients

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5 good but small RCTs were identified for this review of topical tranexamic acid (TXA) for minor oral surgery in patients on anticoagulants. The findings suggest that TXA irrigation and mouthwash may reduce the risk of bleeding.

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Tooth extraction: factors affecting anxiety and fear

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This review of factors affecting fear and anxiety in adult patients undergoing tooth extraction included 16 studies and identified a number of factors associated with anxiety although there are concerns over the quality of the available studies.

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Third molars: insufficient evidence for removal of impacted asymptomatic disease-free teeth

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This update of an earlier Cochrane review comparing retention or extraction of of asymptomatic disease-free impacted third molars only identified 2 studies of low to very low quality evidence providing insufficient evidence to inform practice.

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Anticoagulant therapy and dental extractions

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This review the bleeding risk of patients continuing or discontinuing oral anticoagulant therapy found no increase bleeding risk in those continuing anticoagulant therapy.

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Do analgesics before dental treatment reduce post treatment pain in children?

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This Cochrane review found 5 RCTs of pre-op analgesics prior to dental treatment for children under local anaesthetic. The evidence as insufficient to determine a benefit but there may be a benefit prior to orthodontic band placement. Further high quality studies are needed.

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Palatal injections for maxillary extractions: are they needed?

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This review of the use of palatal injections for maxillary extractions included 15 studies. While the findings suggest that they may not be needed further high quality studies are needed to confirm the findings.

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