Clinical Oral Investigations

, Volume 23, Issue 1, pp 477–484 | Cite as

Bleeding related to dental treatment in patients taking novel oral anticoagulants (NOACs): a retrospective study

  • Eun-Jung Kwak
  • Sangook Nam
  • Kyeong-mee Park
  • Seo-yul Kim
  • Jisun Huh
  • Wonse ParkEmail author
Original Article



Several novel oral anticoagulants (NOACs) are currently prescribed for patients suffering from atrial fibrillation, pulmonary thromboembolism, and venous thrombosis. However, there is no clinical guideline for dental treatment in patients taking NOACs. This study investigated bleeding events related to various dental treatments.

Materials and methods

This retrospective study included 120 patients (153 cases) who were prescribed NOACs and received dental procedures in the Department of Advanced General Dentistry at Yonsei University Dental Hospital from January 2014 to June 2017. The indication for NOACs, initiation of NOACs, duration of discontinuance, creatinine clearance, and type of dental treatment were investigated. Bleeding events were assessed at a follow-up visit to the clinic.


Postoperative bleeding occurred in only 9 of the 153 included cases; they comprised 2 cases of scaling, 3 cases of simple extraction, 3 cases of the first stage of implant surgery, and 1 case of resin filling. The creatinine clearance (P = .111) and duration of discontinuance (P = .222) did not differ significantly between the groups with and without bleeding events.


Our data indicate that most dental treatments may be performed in patients taking NOACs without an increased likelihood of bleeding events regardless of the discontinuance duration. Moreover, any postoperative bleeding can be stopped by applying compressive pressure or local hemostatic agents.

Clinical relevance

Our study suggests that patients taking NOACs who need dental treatments may have a bleeding tendency based on our retrospective data. Preoperative history taking and treatment modification should therefore be considered before performing dental surgery.


Novel oral anticoagulants Direct oral anticoagulant Dental treatment Bleeding 



This research was supported by the Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Education (grant no. 2017R1D1A1B03033657).

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with animals performed by any of the authors. All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Formal consent is not required for this type of study.


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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Eun-Jung Kwak
    • 1
  • Sangook Nam
    • 1
  • Kyeong-mee Park
    • 1
  • Seo-yul Kim
    • 1
  • Jisun Huh
    • 1
  • Wonse Park
    • 1
    Email author
  1. 1.Department of Advanced General Dentistry, College of DentistryYonsei UniversitySeoulSouth Korea

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