In short
Do not stop warfarin or a direct oral anticoagulant for routine dental surgery, including extractions. Across decades of studies and more than eleven thousand procedures in anticoagulated patients, bleeding requiring more than local measures was rare and never fatal, while interruption for dental procedures has been followed by embolic events including deaths. The bleeding is a problem you can see and control in the chair; the stroke happens at home. Manage bleeding locally, know the INR or the DOAC timing, and reserve any change in therapy for the physician who prescribed it, for the rare case that needs one.
Full piece · registered dentists
The scenario, the mechanism, the precautions and the sources are available to registered dentists. Registration is free and takes a moment: your name, your email, and your NPI, which is checked against the public NPPES registry. Nothing is sold and no list is shared.