New oral anticoagulantsimplications in odontology

Resumen

The number of patients with cardiovascular problems who come in for dental consultation has increased in the recent years. The most prevalent cardiovascular pathologies are: hypertension, ischemic heart disease and arrhythmias, with atrial fibrillation (AF) being the most common. One of the fundamental pillars of care for patients with AF is prevention of thromboembolic stroke because of its severity and the potential for prevention with the use of anticoagulant drugs. Vitamin-K antagonists have been the most widely used anticoagulants over the past 50 years. However, the advent of new oral anticoagulants (NOACs), supported by clinicaltrialsin more than 50,000 patients, has led to a revolution in cardiovascular therapy that is changing the recommendations of international clinical practice guidelines for the treatment of AF. As a result, anticoagulant treatment with NOACsis a therapeutic challenge for dentists and we should be familiar with its treatment protocol, since despite being safer drugs, they can complicate an hemorrhagic event, for there is no antidote (except in the case of Dabigatran). The purpose of this review is to provide an update on the new oral anticoagulants and their implications on dental treatment. Dabigatran, Rivaroxaban and Apixaban are reviewed, along with their pharmacological properties, indications and contraindications, as well as the protocol to be followed in the event of an intervention that results in bleeding in the oral cavity.