Neurology
Dental Management of Patients with Stroke / CVA (history)
Stress reduction; review antithrombotics
Post-stroke patients are frequently on antiplatelet/anticoagulant therapy — assess bleeding risk. Short, low-stress appointments.
Emergency vs routine management
If EMERGENCY — what to do
- • Signs of a new stroke (FAST): call emergency services immediately.Ref: Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- • Urgent care can proceed with local haemostasis; continue antithrombotics.Ref: SDCEP. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd ed., 2022
If ROUTINE — what to do
- • Defer elective care for ~6 months after stroke.Ref: Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- • Continue antiplatelet/anticoagulant therapy; short low-stress appointments.Ref: Kleindorfer DO et al. 2021 AHA/ASA Guideline for Prevention of Stroke in Patients With Stroke and TIA. Stroke 2021;52:e364–e467
Clinical precautions
- • Assess concurrent antithrombotic therapy
- • Short low-stress appointments
- • Consider communication/mobility needs
At a glance by procedure
Initial assessment before lab results or timing details are entered.
| Procedure | Initial assessment |
|---|---|
| Examination / radiographs | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Supragingival scaling / polish | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Deep scaling / subgingival RSD (subgingival calculus) | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Root canal treatment | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Simple extraction (1–3 teeth) | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Surgical / bony extraction | MODIFY / CAUTION Stress reduction; review antithrombotics |
| Implant placement | MODIFY / CAUTION Stress reduction; review antithrombotics |
References
- CVA — dental management
- Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)
- SDCEP. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd ed., 2022
- Little JW, Miller CS et al. Dental Management of the Medically Compromised Patient, 10th ed., Elsevier 2023
- Kleindorfer DO et al. 2021 AHA/ASA Guideline for Prevention of Stroke in Patients With Stroke and TIA. Stroke 2021;52:e364–e467
Related guides
This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.