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To the Editor:
Reference is made to the article by Behrman and Wright, "Dental Surgery During Continuous Anticoagulant Therapy" (JAMA175: 483 [Feb. 11] 1961), in which the authors state that my report of experience with 2 patients "appears to have been unduly alarming."Our 2 patients, both maintained at hypoprothrombinemic levels within the range recommended by Dr. Wright, underwent dental extraction performed by the chief of the dental service of a VA hospital. In both our patients, bleeding could only be controlled by returning the prothrombin level to normal by the use of vitamin K1 oxide. In view of a fall in the hemoglobin level from 14.0 to 7.1 gm. per 100 cc. before appropriate therapy was instituted, we feel that 1 patient might have died of exsanguination. It should be emphasized that this same patient who hemorrhaged profusely following 2 separate extractions under hypoprothrombinemia had no difficulty
Ziffer AM. Dental Therapy During Anticoagulant Therapy. JAMA. 1961;177(6):461. doi:10.1001/jama.1961.03040320105014