1. Clinical Tips
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    It's 10 p.m.; do you know where your patient's hemostasis is?

    Nov. 18, 2015
    If you are a dentist who performs surgical treatment, such as extractions and/or implant therapy, a dreaded phone call can be from your emergency service regarding a patient you treated earlier in the day who now has uncontrollable bleeding. This is of greater concern if the patient has a medical history that warrants anticoagulation medication and the physician did not let your patient go off medication prior to surgery. Dr. Scott Froum, editorial director of Perio-Implant Advisory, introduces the feature article on hemostasis that will help you answer pertinent questions prior to surgery.
    Scott Froum, DDS, Editorial Director
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    If you are a dentist who engages in surgical treatment, such as extractions and/or implant therapy, a dreaded phone call can be from your emergency service regarding a patient you treated earlier in the day who now has uncontrollable bleeding. This is of greater concern if the patient has a medical history that warrants anticoagulation medication and the physician did not let your patient go off medication prior to surgery. Are all anticoagulation medications equal in their ability to predispose your patient to bleeding? What is the difference between aspirin, Coumadin, Plavix, Pradaxa, Eliquis, and heparin? What is your patient being anticoagulated for, and at what therapeutic level should they be? When should you order an INR test versus a bleeding time?

    These are just a few of the questions that you should be able to answer prior to engaging in surgical treatment. Of course, an open discussion with the patient’s physician is certainly warranted whenever you have questions about a patient’s medication and medical history. Dr. Gregg Jacob, attempts to answer many of these questions about hemostasis in this month’s feature article. He offers a decision matrix as to when patients should be given home-care instructions and when they should come back to the office for hemostatic measures.

    MORE CLINICAL TIPS FROM DR. SCOTT FROUM . . .
    'Help! My implant fell out!'
    'How much do you charge for an implant? I just want to know the price!'
    ‘The implant you put in my mouth is now bleeding; what should I do?’
    After a tooth extraction, are you guilty of chucking the tissue?

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    Scott Froum, DDS, is a periodontist in private practice in New York City. He is the editorial director of Perio-Implant Advisory e-newsletter, as well as a contributing author for DentistryIQ and Dental Economics. Dr. Froum is a clinical associate professor at the New York University Dental School in the Department of Periodontology and Implantology, and a diplomate of the American Board of Periodontology. Contact him through his website at www.drscottfroum.com.

    About the Author

    Scott Froum, DDS | Editorial Director

    Scott Froum, DDS, a graduate of the State University of New York, Stony Brook School of Dental Medicine, is a periodontist in private practice at 1110 2nd Avenue, Suite 305, New York City, New York. He is the editorial director of Perio-Implant Advisory and serves on the editorial advisory board of Dental Economics. Dr. Froum, a diplomate of both the American Academy of Periodontology and the American Academy of Osseointegration, is a volunteer professor in the postgraduate periodontal program at SUNY Stony Brook School of Dental Medicine. He is a PhD candidate in the field of functional and integrative nutrition. Contact him through his website at drscottfroum.com or (212) 751-8530.

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