Objective: To analyze the clinical treatment experience and aesthetic effect of tooth extraction in elderly patients taking oral anticoagulant drugs, and to provide a theoretical basis for clinical practice. Methods: Forty elderly patients who underwent tooth extraction with oral anticoagulant drugs from November 2020 to November 2021 were selected as the study group, and 40 elderly patients who underwent tooth extraction without taking anticoagulant drugs during the same period were selected as the reference group. The clinical differences between the two groups were compared. Result: Compared with the reference group, the incidence of bleeding, PT, APTT and international standardization rate at 30 seconds and 1 hour after surgery in the study group was higher, while the incidence of PLT and complications was lower (P < 0.05). Comparison of tissue healing rate and appearance satisfaction score 10 days after surgery between the two groups (P > 0.05). Compared with the pollivi group, the incidence of bleeding was lower in the warfarin group at 30 seconds and 1 hour after surgery (P < 0.05), and compared with the pollivi group, the incidence of bleeding was lower in the aspirin group at 30 seconds and 1 hour after surgery (P < 0.05). The comparison of anticoagulation indicators and international standardization rates of different anticoagulant drugs in the research group (P < 0.05). Conclusion: For elderly patients undergoing tooth extraction, long-term oral administration of anticoagulant drugs increases the risk of early postoperative bleeding, and there are differences in the degree of bleeding among different drugs. Under standardized operation and perioperative management, the satisfaction of tissue healing and appearance was comparable to that of those who did not take the medication. In clinical practice, attention should be paid to the use of anticoagulant drugs by patients, postoperative monitoring should be strengthened, and bleeding should be intervened in a timely manner to ensure the safety and aesthetic effect of treatment.