When children continued antithrombotic drugs before dental treatment, they are at high risk for bleeding, but if they discontinued antithrombotic drugs, they are at high risk for thromboembolism. This research aims to study
factors of dental treatment in clinic and under general anesthesia (GA), and characteristics of related treatments. A retrospective chart review in the cases of Dental department, Siriraj Hospital consist of 305 children under 18 years old who received antithrombotic drugs. 232 children received treatment in clinic, in which 222 cases continued antithrombotic drugs. 73 children received treatment under GA, in which 72 cases discontinued antithrombotic drugs. The results show both groups have significant differences in sex, age, age group, type of antithrombotic drugs, local hemostasis (P<0.001) and INR range of children on warfarin (P=0.014). The treatment in clinic group mean age is 8.7±3.4 years. These antithrombotic drugs are aspirin (67.2%) and warfarin (24.6%). They mostly receive scaling, followed by tooth extraction (Mean 1.2 teeth/case) and use gauze, gel foam and gauze for local hemostasis, and INR range are mostly 1.50-3.50. The treatment under GA mean age is 5.7±2.6 years. These antithrombotic drugs are aspirin (90.5%) and warfarin (4.1%). They mostly receive tooth extraction (Mean 6.4 teeth/case) and use gel foam, suture and gauze for local hemostasis, and INR range are mostly 1.00-1.49. This study shows no incidences of bleeding and thromboembolic complications after dental treatment in both groups. These results suggest that dentists can perform pediatric dental treatment in clinic safely without interrupting antithrombotic drugs combine with appropriate local hemostasis. However, dental treatment under GA should be considered by dentist, pediatrician and anesthesiologist to weigh bleeding and thromboembolic risks, and the need to discontinue or continue antithrombotic drugs. These must be made case by case and should be combined with effective local hemostasis.