Revista de Odontologia da UNESP
https://revodontolunesp.com.br/article/doi/10.1590/1807-2577.09718
Revista de Odontologia da UNESP
Original Article

Avaliação do nível de conhecimento de cirurgiões-dentistas e graduandos em Odontologia quanto ao manejo de indivíduos em uso de anticoagulantes orais

Assessment of dentists and dental students’ level of knowledge in the management of individuals using oral anticoagulants

Liciane dos Santos MENEZES; Rosany Larissa Brito DE OLIVEIRA; Luiz Carlos Ferreira DA SILVA

http://dx.doi.org/10.1590/1807-2577.09718 Rev. odontol. UNESP, vol.47, n5, p.321-327, 2018
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Resumo

Resumo: Introdução: Diante da alta incidência das doenças cardiovasculares, muitos são os pacientes que fazem uso de medicações para prevenção e tratamento dessas desordens. Consequentemente, o número de pessoas em uso de anticoagulantes orais a serem submetidas a tratamento odontológico é crescente e o manejo desses indivíduos requer criteriosa avaliação da condição clínica e do procedimento a ser realizado.

Objetivo: Avaliar o nível de conhecimento de cirurgiões-dentistas e graduandos em Odontologia quanto ao manejo de indivíduos em uso de anticoagulantes orais a serem submetidos a tratamento odontológico.

Material e método: Investigação descritiva, quantitativa, de corte transversal, com base em um questionário respondido por 100 indivíduos, sendo 70 cirurgiões-dentistas e 30 graduandos do curso de Odontologia, escolhidos por conveniência, para avaliar o conhecimento sobre o tema proposto. Para comparação das variáveis quantitativas, foi utilizado o Teste t de student, para comparação de duas amostras, e o Teste ANOVA, com pós-teste de Bonferroni, para comparação de três amostras.

Resultado: Dentre os entrevistados, 74,5% dos cirurgiões-dentistas e 54,2% dos graduandos relataram já ter atendido um paciente que faz uso de anticoagulante oral. Não houve diferença estatística quanto ao desempenho entre profissionais e alunos acerca do manejo odontológico de pacientes em uso de anticoagulantes. Dentre o grupo de cirurgiões-dentistas, os profissionais da cirurgia bucomaxilofacial e os que fizeram residência multiprofissional apresentaram melhor desempenho quando comparados aos clínicos gerais.

Conclusão: Pôde-se concluir que, para os grupos estudados, o manejo de pessoas em uso de anticoagulantes orais ainda é um desafio.

Palavras-chave

Anticoagulantes, inibidores da agregação de plaquetas, odontologia

Abstract

Abstract: Introduction: Cardiovascular diseases have a high incidence and due to that there is a large amount of patients who take medications for prevention and treatment of these disorders. Consequently, the number of people to be submitted to dental treatment and also under oral anticoagulant therapy is increasing and the management of these individuals requires a careful evaluation of the clinical condition and the procedure to be performed.

Objective: To evaluate the level of knowledge of dentists and undergraduate dental students in the management of individuals using oral anticoagulants to be submitted to dental treatment.

Material and method: Descriptive, quantitative, cross-sectional study based on a questionnaire answered by 100 individuals (70 dentists and 30 undergraduate dental students), chosen for convenience to evaluate their knowledge about the proposed topic. To compare the quantitative variables, the Student's T test was used to compare two samples and the ANOVA test with Bonferroni's post test to compare three samples.

Result: Among the interviewees, 74.5% of dental surgeons and 54.2% of undergraduates reported having attended a patient under oral anticoagulant therapy. There was no statistical difference regarding the performance between professionals and students in the dental management of patients taking anticoagulants. Among the group of dental surgeons, the professionals of the bucomaxillofacial surgery and those who had multiprofessional residency presented better performance when compared to the general practitioners.

Conclusion: The management of patients using oral anticoagulants stills a challenge for the groups studied.
 

Keywords

Anticoagulants, platelet aggregation inhibitors, dentistry

References

Mingarro-de-León A, Chaveli-López B. Alternative to oral dicoumarin anticoagulants: considerations in dental care. J Clin Exp Dent. 2013 Dec 1;5(5):e273-8. http://dx.doi.org/10.4317/jced.51226. PMid: 24455094.

Shi Q, Xu J, Zhang T, Zhang B, Liu H. Post-operative bleeding risk in dental surgery for patients on oral anticoagulant therapy: a meta-analysis of observational studies. Front Pharmacol. 2017 Feb 8;8:58. http://dx.doi.org/10.3389/fphar.2017.00058. PMid: 28228727.

van Diermen DE, van der Waal I, Hoogvliets MW, Ong FN, Hoogstraten J. Survey response of oral and maxillofacial surgeons on invasive procedures in patients using antithrombotic medication. Int J Oral Maxillofac Surg. 2013 Apr;42(4):502-7. http://dx.doi.org/10.1016/j.ijom.2012.09.018. PMid:23123097.

Chinnaswami R, Bagadia RK, Mohan A, Kandaswamy E, Chandrasekaran D. Dentists’ knowledge, attitude and practice in treating patients taking oral antithrombotic medications – a survey. J Clin Diagn Res. 2017 Jan;11(1):ZC88-91. http://dx.doi.org/10.7860/JCDR/2017/23648.9236. PMid:28274053.

Hong CH, Islam I. Anti-thrombotic therapy: implications for invasive outpatient procedures in dentistry. J Blood Disord Transfus. 2013;4:166. http://dx.doi.org/10.4172/2155-9864.1000166.

Costantinides F, Rizzo R, Pascazio L, Maglione M. Managing patients taking novel oral anticoagulants (NOAs) in dentistry: a discussion paper on clinical implications. BMC Oral Health. 2016 Jan;16(1):5. http://dx.doi.org/10.1186/s12903-016-0170-7. PMid:26822674.

Curto A, Curto D, Sanchez J. Managing patients taking edoxaban in dentistry. J Clin Exp Dent. 2017 Feb 1;9(2):e308-e311. http://dx.doi.org/10.4317/jced.53431. PMid: 28210454.

Rai R, Mohan B, Babbar V, Dang N. Practices and perceptions of doctors for patients on anti-platelets during dental surgery: a national survey. J Maxillofac Oral Surg. 2014 Sep;13(3):249-52. http://dx.doi.org/10.1007/s12663-013-0523-6. PMid:25018596.

Little JW, Miller CS, Henry RG, McIntosh BA. Antithrombotic agents: implications in dentistry. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2002 May;93(5):544-51. http://dx.doi.org/10.1067/moe.2002.121391. PMid:12075203.

Campbell JH, Alvarado F, Murray RA. Anticoagulation and minor oral surgery: should the anticoagulation regimen be altered? J Oral Maxillofac Surg. 2000 Feb;58(2):131-5, discussion 135-6. http://dx.doi.org/10.1016/S0278-2391(00)90324-0. PMid:10670590.

Beirne OR. Evidence to continue oral anticoagulant therapy for ambulatory oral surgery. J Oral Maxillofac Surg. 2005 Apr;63(4):540-5. http://dx.doi.org/10.1016/j.joms.2004.12.009. PMid:15789328.

Dézsi CA, Dézsi BB, Dézsi AD. Management of dental patients receiving antiplatelet therapy or chronic oral anticoagulation: a review of the latest evidence. Eur J Gen Pract. 2017 Dec;23(1):196-201. http://dx.doi.org/10.1080/13814788.2017.1350645. PMid:28743214.

Cartwright A. Professionals as responders: variations in and effects of response rates to questionnaires, 1961-77. BMJ. 1978 Nov;2(6149):1419-21. http://dx.doi.org/10.1136/bmj.2.6149.1419. PMid:719433.

Brazier JE, Harper R, Jones NM, O’Cathain A, Thomas KJ, Usherwood T, et al. Validating the SF-36 health survey questionnaire: new outcome measure for primary care. BMJ. 1992 Jul;305(6846):160-4. http://dx.doi.org/10.1136/bmj.305.6846.160. PMid:1285753.

Krishnan B, Shenoy NA, Alexander M. Exodontia and antiplatelet therapy. J Oral Maxillofac Surg. 2008 Oct;66(10):2063-6. http://dx.doi.org/10.1016/j.joms.2008.06.027. PMid:18848103.

Mekaj YH, Mekaj AY, Duci SB, Miftari EI. New oral anticoagulants: their advantages and disadvantages compared with vitamin K antagonists in the prevention and treatment of patients with thromboembolic events. Ther Clin Risk Manag. 2015 Jun;11:967-77. http://dx.doi.org/10.2147/TCRM.S84210. PMid:26150723.

Mansur AP, Favarato D. Trends in mortality rate from cardiovascular disease in Brazil, 1980-2012. Arq Bras Cardiol. 2016 Jul;107(1):20-5. http://dx.doi.org/10.5935/abc.20160077. PMid:27223642.

Brennan MT, Wynn RL, Miller CS. Aspirin and bleeding in dentistry: an update and recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2007 Sep;104(3):316-23. http://dx.doi.org/10.1016/j.tripleo.2007.03.003. PMid:17618144.

Murphy J, Twohig E, McWilliams SR. Dentists’ approach to patients on anti-platelet agents and warfarin: a survey of practice. J Ir Dent Assoc. 2010 Feb-Mar;56(1):28-31. PMid:20337143.

Sáez-Alcaide LM, Sola-Martín C, Molinero-Mourelle P, Paredes-Rodríguez V, Zarrias-Caballero C, Hernández-Vallejo G. Dental management in patients with antiplatelet therapy: a systematic review. J Clin Exp Dent. 2017 Aug 1;9(8):e1044-e1050. http://dx.doi.org/10.4317/jced.54079. PMid: 28936297.

Dantas AK, Deboni MCZ, Piratininga JL. Cirurgias odontológicas em usuários de anticoagulantes orais. Rev Bras Hematol Hemoter. 2009 Jan 21;31(5):337-40. http://dx.doi.org/10.1590/S1516-84842009005000071.

Owens CD, Belkin M. Thrombosis and coagulation: operative management of the anticoagulated patient. Surg Clin North Am. 2005 Dec;85(6):1179-89, x. http://dx.doi.org/10.1016/j.suc.2005.09.008. PMid:16326201.

Blinder D, Manor Y, Martinowitz U, Taicher S. Dental extractions in patients maintained on oral anticoagulant therapy: comparison of INR value with occurrence of postoperative bleeding. Int J Oral Maxillofac Surg. 2001 Dec;30(6):518-21. http://dx.doi.org/10.1054/ijom.2001.0172. PMid:11829234.

Hoffbrand AV, Moss PAH. Fundamentos em hematologia de Hoffbrand. 7 ed. Porto Alegre: Artmed; 2018.

Dewan K, Bishop K, Muthukrishnan A. Management of patients on warfarin by general dental practitioners in South West Wales: continuing the audit cycle. Br Dent J. 2009 Feb 28;206(4):E8; discussion 214-5. http://dx.doi.org/10.1038/sj.bdj.2009.112.
 

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