An assessment of the management of patients on warfarin by general dental practitioners in South West Wales.

For anticoagulation therapy, warfarin is used to reduce the risk of thrombo-embolic events in patients with mechanical prosthetic heart valves, certain cardiovascular conditions, deep vein thrombosis (DVT) and hypercoagulable states.(1). The International Normalised Ratio (INR) is used as a measure of anticoagulation and is expressed as a ratio of the patient's prothrombin time (PT) to control prothrombin time. In a person with a normal PT, the INR is approximately 1. The therapeutic range is the value of INR or degree of anticoagulation required to prevent the development of serious thrombo-embolism and is normally maintained between 2.0 and 4.5. It is important to recognize that the INR is only valid for patients on well controlled anticoagulant therapy, ie where the level of anticoagulation is reasonably stable over a moderate length of time.(2).