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Oral Health Topics

Anticoagulant and Antiplatelet Medications and Dental Procedures

Key Points

There is both a growing number of individuals prescribed anticoagulation or antiplatelet therapy, as well as medications for this purpose. There is strong evidence for the older medications, as well as limited evidence for the new medications that, for most patients, it is not necessary to alter anticoagulation or antiplatelet therapy prior to dental intervention.

Drug Class Drug Names
  • warfarin (Coumadin®)
Antiplatelet agents*
  • clopidogrel (Plavix®)
  • ticlopidine (Ticlid®)
  • prasugrel (Effient®)
  • ticagrelor (Brilinta®)
  • aspirin
Target-specific oral anticoagulants**
  • dabigatran (Pradaxa®)
  • rivaroxaban (Xarelto®)
  • apixaban (Eliquis®)
  • edoxaban (Savaysa® [Lixiana® in Europe, Japan, elsewhere])

* Strong evidence
** Limited evidence

Typical Patient

No need to discontinue medication; use local measures to control bleeding

Patients with Higher Risk of Bleeding

Any suggested modification to the medication regimen prior to dental surgery should be done in consultation with and on advice of the patient’s physician

  • Introduction
  • Evidence: Warfarin and Antiplatelet Agents
  • Evidence: Target-Specific Oral Anticoagulants
  • Summary
  • References
  • Addtional ADA Resources
  • Other Resources

Prepared by: Center for Science Information, ADA Science Institute
Last Updated: October 22, 2015