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Oral Health Topics

Oral 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 (i.e., warfarin, antiplatelet agents), as well as limited evidence for the newer direct-acting oral anticoagulants 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
Direct-acting 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: Direct-Acting Oral Anticoagulants
  • Evidence: Warfarin and Antiplatelet Agents
  • Other Patient Considerations
  • Summary
  • References
  • ADA Resources
  • Other Resources
Last Updated: September 14, 2020

Prepared by:

Department of Scientific Information, Evidence Synthesis & Translation Research, ADA Science & Research Institute, LLC.


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