What is a primary goal of maintaining INR in the therapeutic range for a patient undergoing dental extraction?

• A. Achieve a normal INR of 1.0.
• B. Reverse anticoagulation entirely.
• C. Maximize anticoagulation.
• D. Balance the risk of bleeding with the risk of thrombosis by maintaining INR in therapeutic range.

Answer: (D)

Maintaining INR within the therapeutic range during a dental extraction aims to balance two competing risks: bleeding if the anticoagulation effect is too high, and thrombosis if it is too low. The therapeutic range is set to protect against clot formation while still allowing enough hemostasis for the procedure when appropriate local hemostatic measures are used. This approach avoids stopping anticoagulation entirely or driving it to maximal effect, which would either increase thrombotic risk or excessive bleeding. In short, the goal is to keep the patient’s INR in a level that minimizes bleeding during the procedure without elevating the risk of a thrombotic event.