A controlled clinical study of periodontal health in anticoagulated patients: Assessment of bleeding on probing

BACKGROUND: According to the Spanish Society of Cardiology, 700,000 patients receive oral anticoagulants, and in these cases bleeding on probing (BOP) could be altered. However, no studies have analyzed the periodontal status of these patients and the effects anticoagulants may have upon BOP. A study was made of the possible relationship between plaque index, probing depth, INR (International Normalized Ratio) and acenocoumarol dose versus the clinical signs of BOP in a sample of anticoagulated patients. Likewise, an analysis was made of oral hygiene habits and attitude towards bleeding in these patients. MATERIAL AND METHODS: A controlled observational clinical study was made in La Ribera Hospital (Valencia, Spain) involving 44 anticoagulated patients treated with Sintrom® (acenocoumarol) and a homogeneous control group of 44 non-anticoagulated patients. A survey on oral hygiene habits and attitude towards bleeding was carried out, and the main periodontal parameters were recorded. RESULTS: Probing depth was the parameter with the strongest correlation to BOP (p<0.001), followed by the plaque index (p<0.002). In contrast, no relationship was observed between acenocoumarol dose or INR and BOP. Mean BOP was greater in the control group than in the anticoagulated group (p<0.001). Oral hygiene habits and attitude towards bleeding differed significantly between groups. CONCLUSIONS: We have found no explanation why BOP was greater in the control group. What seems clear is that in the presence of the same plaque index and probing depth, anticoagulated patients did not bleed more than non-anticoagulated patients. A lack of knowledge of health and oral hygiene habits was observed in these subjects. Key words:Anticoagulant therapy, bleeding on probing, periodontal health.