Managing Hemostasis in Dental Practice: Challenges and Solutions

Excessive bleeding can complicate various office dental procedures, potentially leading to increased morbidity or reluctance to undergo similar treatments in the future. While many clinical guidelines consider dental interventions to be minor with a low risk of bleeding, patients undergoing anticoagulation therapy face a heightened risk of bleeding both during and after these procedures. This risk is also relevant for patients diagnosed with hereditary bleeding disorders like von Willebrand disease or Hemophilia, as well as those with no prior history of bleeding complications. These situations may necessitate the use of topical hemostatic agents. This article will explore the mechanisms, practical uses, effectiveness, and potential side effects of commonly used topical hemostatic agents in-office dental surgery, including gelatin sponges, collagen, oxidized regenerated cellulose (ORC), oxidized cellulose, fibrin sealants, flowable hemostats, adhesives, sutures, electrocautery, and topical thrombin.