[The questionnaire survey to clarify correspondence of medical doctors and dentists in Fukuoka City, Japan, for warfarin therapy at the dental extraction].

No to shinkei = Brain and nerve Pub Date : 2006-10-01
Masahiro Yasaka, Yasushi Okada, Tooru Inoue, Hiromasa Yoshikawa, Motonori Saku
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Abstract

Purpose: The questionnaire survey was performed in order to clarify correspondence of medical doctors and dentists working at hospital service for warfarin therapy at the dental extraction.

Methods: For 17 senior dentists in 17 hospitals and 142 senior physicians in 82 hospitals in Fukuoka City, we investigated using the questionnaire whether they supported dental extraction under warfarin therapy or not in patients having warfarin treatment with past history of cardioembolic stroke due to non-valvular atrial fibrillation (NVAF). Specialty and experience of stroke after withdrawal of warfarin were also asked in medical doctors.

Result: The reply was obtained from 14 dentists (82.4%) and 66 doctors (46.5%). The number of dentists and doctors who pull out a tooth under warfarin treatment continuation were 12 persons (85.7%) and 32 persons (48.5%), respectively. The rates in doctors whose specialty was stroke, cardiovascular disease, and others were 78.6% (11/14), 36.0% (9/25), and 44.4% (12/27), respectively. The rate in stroke specialists was significantly higher than that in cardiovascular disease specialists (p = 0.019). The stroke specialists had experience of stroke after withdrawal of warfarin more frequently than the cardiovascular disease specialists (57.1% vs. 20.0%, p = 0.033).

Conclusion: The rates of acceptance in tooth extraction under warfarin treatment continuation of the dentist were high in Fukuoka city, while that of the medical doctors were not. Rate of doctor's acceptance differed according to the specialties, and may be affected by experience of stroke after cessation of warfarin therapy.

[问卷调查以澄清日本福冈市医生和牙医在拔牙时华法林治疗的对应关系]。
目的:通过问卷调查,了解在医院工作的医生和牙医对华法林治疗拔牙的对应关系。方法:对福冈市17家医院的17名高级牙医和82家医院的142名高级医师进行问卷调查,对既往有非瓣膜性心房颤动(NVAF)所致心源性卒中患者接受华法林治疗后是否支持拔牙。还向医生询问了华法林停药后中风的专科和经验。结果:共有14名牙医(82.4%)和66名医生(46.5%)回复。在华法林继续治疗期间拔牙的牙医及医生分别有12人(85.7%)及32人(48.5%)。卒中、心血管疾病和其他专科的患病率分别为78.6%(11/14)、36.0%(9/25)和44.4%(12/27)。卒中专科医生的患病率明显高于心血管疾病专科医生(p = 0.019)。卒中专科患者停用华法林后卒中发生率高于心血管专科患者(57.1% vs. 20.0%, p = 0.033)。结论:福冈市牙科医生继续华法林治疗拔牙的接受率较高,而内科医生的接受率较低。医生的接受率因专科不同而不同,并可能受停止华法林治疗后卒中经历的影响。
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