Periodontics · single question
A patient taking warfarin bleeds when flossing. What is the primary cause?
Show answer and explanation
Correct answer: A. Gingival inflammation from plaque (antiplaque action of flossing)
Bleeding on flossing is a clinical sign of GINGIVITIS — caused by inflammation from dental plaque. While warfarin impairs clotting, bleeding on flossing is primarily caused by UNDERLYING INFLAMMATION (gingivitis) from plaque accumulation, not directly from warfarin. Warfarin may intensify bleeding but plaque-induced inflammation is the root cause. The source cites 'antiplaque action' as the answer.
- A. Incorrect in this context. Warfarin impairs clotting but the source specifically cites antiplaque action as the cause.
- B. CORRECT. Bleeding on flossing indicates gingival inflammation from plaque — the antiplaque action of flossing disrupts plaque, and inflamed gingiva bleeds.
- C. Incorrect. Warfarin has no direct gingival toxicity.
- D. Incorrect. Warfarin inhibits clotting factor synthesis (II, VII, IX, X) — does not cause thrombocytopenia.