1424 Correspondence Interruption of Warfarin Anticoagulation for Dental Surgery To the Editor:

When performing dental surgery in patients receiving warfarin for anticoagulation, clinicians must weigh the risk of bleeding com-plications in continuous anticoagulation vs that of thromboembolic complications with anticoagulation interruption. Multiple studies have shown that dental surgery (including extractions) can be per-formed safely at therapeutic international normalized ratio (INR) levels (INR 3.5) with local hemostatic measures. Of the few cases needing more than local hemostatic measures (eg, vitamin K injection and/or fresh frozen plasma), most involved higher than therapeutic INR levels, and none was fatal. On the other hand, there have been many documented cases of serious thromboem-bolic complications (including deaths) after anticoagulation inter-ruption for medical/dental procedures