Oral and maxillofacial surgery: extraction in anticoagulated patients: practice question

A Dentistry question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Dentistry · Oral and maxillofacial surgery: extraction in anticoagulated patients

Sample item

A man on warfarin for atrial fibrillation needs a simple dental extraction. His INR is 2.4. What is the best approach?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

C. Proceed with local haemostatic measures without stopping warfarin

Simple extractions can be done safely with INR in the therapeutic range, generally below about 3.5, using local measures such as sutures, tranexamic acid mouthwash and pressure. Stopping warfarin risks thromboembolism.

Option by option

  • A. Admit for heparin bridging for every extraction

    Bridging is not routinely needed for simple extractions.

  • B. Stop warfarin for 2 weeks

    Stopping warfarin exposes the patient to stroke risk without need.

  • C. Proceed with local haemostatic measures without stopping warfarin (correct)

    Correct. Local measures are adequate with an INR in range.

  • D. Give vitamin K before the extraction

    Vitamin K reverses anticoagulation unnecessarily.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Dentistry question

What is the answer to this Dentistry question?

The best answer is C, Proceed with local haemostatic measures without stopping warfarin. Simple extractions can be done safely with INR in the therapeutic range, generally below about 3.

Why is "Admit for heparin bridging for every extraction" not the answer?

Bridging is not routinely needed for simple extractions.

Why is "Stop warfarin for 2 weeks" not the answer?

Stopping warfarin exposes the patient to stroke risk without need.

Why is "Give vitamin K before the extraction" not the answer?

Vitamin K reverses anticoagulation unnecessarily.

What concept does this question test?

It tests Oral and maxillofacial surgery: extraction in anticoagulated patients in Dentistry. 5, using local measures such as sutures, tranexamic acid mouthwash and pressure. Stopping warfarin risks thromboembolism.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Oral and maxillofacial surgery: extraction in anticoagulated patients?

Learn the dental formula, eruption ages and tooth structure once, as tables. Then use the flashcards and the other Dentistry questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.