Uses Of Coagulants In Dentistry

Uses Of Coagulants In Dentistry

Write Short Note On Astringents In Dental Practice.
Or
Write Short Note On Uses Of Coagulants In Dentistry.
Answer:

Astringents should be used in the following conditions in dental practice:

• Vitamin C deficiency impairs collagen synthesis and causes bleeding gums and excessive post-extraction blood loss. Scurvy should be corrected before elective dental surgery. In case of emergency surgery, careful packing and pressure can stop the bleeding.
• Long-term corticosteroid therapy can also compromise hemostasis by impairing vessel retraction as well as by reducing platelet count. If dental surgery is implicated astringents should be used.
• Platelet function may be deficient due to thrombocytopenia or the use of drugs that inhibit platelet aggregation. Transfusion of platelet-rich plasma is indicated before dental surgery in patients with low platelet count. Corticosteroid therapy helps to restore platelet count in idiopathic thrombocytopenic purpura.

• Aspirin and other NSAIDs are the most important drugs that inhibit platelet aggregation. A large number of older individuals now receive long-term low-dose aspirin prophylaxis for ischemic heart disease or stroke. Many others receive long-term clopidogrel/ticlopidine for a variety of thromboembolic disorders.
• Several patients with arthritis regularly take NSAIDs. Discontinuation of aspirin for 5 days before dental surgery should be considered. In case this is not possible, proper packing and use of local hemostatics is needed to prevent excess bleeding.
• Even minor dental procedures (like scaling) put the hemophiliac patient at great risk of bleeding. The patient should be covered before and after the procedure with IV infusion of antihemophilic factor along with fibrinogen.

• The antifibrinolytic drug tranexamic acid has adjuvant value by reducing the requirement of an antihemophilic factor. Desmopressin injected IV also helps in checking dental bleeding in hemophiliacs as well as in von Willebrand’s disease by releasing factor VIII and von Willebrand’s factor from the vascular endothelium.
• Any oral surgery in patients on anticoagulant medication requires due care to avoid excessive bleeding. Since the action of IV heparin lasts for only 4–6 hours, the extraction can be scheduled at a time when anticoagulation is minimal.
• Low-dose SC heparin and LMW heparin therapy ordinarily do not increase dental surgery-associated bleeding. The heparin antagonist protamine may be given IV in case of an emergency bleed.