IngentaConnect An Examination of the Bleeding Complications Associated with Herb...

Abstract:

Dental professionals routinely treat patients taking prescription, nonprescription, and herbal medications that are known or have the potential to alter bleeding. Prescription anticoagulant and antiplatelet medications, as well as over-the-counter drugs such as aspirin, are typically taken to reduce the risk of thromboembolic events, including stroke. Herbal supplements are widely used for a variety of indications, and both patients and health care practitioners are often unaware of the anticoagulant and antiplatelet effects that occur as either predictable pharmacologic effects or adverse side effects of herbal medicines. In addition, patient use of these herbal supplements is usually undisclosed to health care providers. The purpose of this literature review is to examine the mechanisms of action of drugs and herbs that alter bleeding, and to educate dental professionals as to the proper care and management of patients using these medications. Decision-making strategies, including interpretation of laboratory tests, and when to discontinue the use of these medications are discussed. Patients undergoing routine dental and dental hygiene procedures do not need to discontinue the use of anticoagulant and antiplatelet medications. However, alterations in drug use may be required for those patients undergoing invasive surgical procedures. It is recommended that herbal supplements must be discontinued 2 weeks prior to receiving invasive surgical procedures. Dental practitioners must learn to weigh the risks of discontinuing drug therapy against the potential risks to patients, and implement risk reduction strategies to minimize adverse bleeding complications associated with dental treatment.

Keywords: Anticoagulants; Antiplatelet medications; Aspirin; Bleeding; Clotting; Dental treatment; Garlic; Ginger; Ginkgo biloba; Ginseng; Herbal supplements; NSAIDS; Platelets; St. John's wort; Warfarin

Document Type: News

Affiliations: 1: Arizona School of Dentistry and Oral Health; USC School of Dentistry 2: Ann Eshenaur Spolarich, RDH, PhD, is a physiologist, practitioner, author, and consultant. She teaches pharmacology at the Arizona School of Dentistry and Oral Health and at the USC School of Dentistry. Leslie Andrews, RDH, MBA, is a former professional educator for Philips Oral Healthcare and is currently immediate past president of the Connecticut Dental Hygienists' Association. She is a speaker and author on alternative medicine.

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An Examination of the Bleeding Complications Associated with Herbal Supplements, Antiplatelet and Anticoagulant Medications