Do antiplatelet drugs increase the risk of bleeding after tooth extraction? A case-crossover study

Akhlaghi, Fahimeh; Khaheshi, Isa; Amirhassani, S.

doi:10.1016/j.ijom.2017.06.002

Cited by 7 publications

(7 citation statements)

References 25 publications

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“…A case-crossover study by Akhlaghi et al in 2017 assessed whether there is indeed a higher risk in these patients who underwent surgery. However, the result was that dental extractions could be addressed without modifying aspirin or clopidogrel therapy, despite some differences between the groups assessed in platelet reactivity and clot formation [40]. The bleeding was measured in patients by performing dual antiplatelet therapy after oral surgery by Medeiros et al, and in patients with dual antiplatelet therapy no complications were noted, so it was not necessary to stop the treatment [41].…”

Section: Discussionmentioning

confidence: 99%

“…The dentist, even in patients undergoing therapy, can perform routine extraction without risk without interrupting or modifying the latter. Patients do not have a greater risk of bleeding, even if they have been in antiplatelet therapy for a long time but, in some cases, as some authors mention in a refined way, the therapy must be personalized for each patient [26,27,28,29,30,31,32,33,34,35,36,37,38,39,40,41,42] Pototski et al in 2007, stated in their work that patients can be treated without risk if their INR is lower than 4.0 [48]. However, other studies assess that the risk of bleeding can be controlled by post-extraction hemostasis maneuvers [49].…”

Section: Discussionmentioning

confidence: 99%

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Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

et al. 2019

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Background: Nowadays, patients involved in antiplatelet therapy required special attention during oral surgery procedures, due to the antiplatelet drugs assumption. The motivations of the assumption may be different and related to the patient’s different systemic condition. For this reason, accordingly to the current international guidelines, different protocols can be followed. The aim of this work is to analyze how the dentist’s approach to these patients has changed from the past to the present, evaluating the risk exposure for the patients. Methods: This review paper considered different published papers in literature through quoted scientific channels, going in search of “ancient” works in such a way as to highlight the differences in the protocols undertaken. The analyzed manuscripts are in the English language, taking into consideration reviews, case reports, and case series in such a way as to extrapolate a sufficient amount of data and for evaluating the past therapeutic approaches compared to those of today. Results: Colleagues in the past preferred to subject patients to substitution therapy with low molecular weight anticoagulants, by suspending antiplatelet agents to treatment patients, often for an arbitrary number of days. The new guidelines clarify everything, without highlighting an increased risk of bleeding during simple oral surgery in patients undergoing antiplatelet therapy. Conclusion: Either patients take these medications for different reasons, because of cardiovascular pathologies, recent cardiovascular events, or even for simple prevention, although the latest research shows that there is no decrease of cardiovascular accidents in patients who carry out preventive therapy. Surely, it will be at the expense of the doctor to assess the patient’s situation and risk according to the guidelines. For simple oral surgery, it is not necessary to stop therapy with antiplatelet agents because the risk of bleeding has not increased, and is localized to a post-extraction alveolus or to an implant preparation, compared to patients who do not carry out this therapy. From an analysis of the results it emerges that the substitutive therapy should no longer be performed and that it is possible to perform oral surgery safely in patients who take antiplatelet drugs, after a thorough medical history. Furthermore, by suspending therapy, we expose our patients to more serious risks, concerning their main pathology, where present.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

et al. 2019

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“…This supports the results of similar studies conducted on patients undergoing other dental surgeries, such as surgical and nonsurgical tooth extraction. 3,7 In patients using antiplatelet drugs, the risk of surgical site bleeding should always be compared against the risk of thrombotic events. Studies of patients with coronary artery disease and at risk of ischemic stroke have shown that ASA withdrawal seriously increases the risk of adverse cardiac and brain ischemic events.…”

Section: Discussionmentioning

confidence: 99%

Do Antiplatelet Drugs Increase the Risk of Bleeding After Dental Implant Surgery? A Case-and-Crossover Study

Khaheshi

Hoseinzadeh

Rezvanpour

et al. 2018

Journal of Oral and Maxillofacial Surgery

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“…But still controversies remains whether to stop or continue anti-platelet therapy. [ 1 ] The clinician must balance the risk of thromboembolism by reducing or stopping antiplatelet therapy against the risk of triggering excessive post extraction bleeding if antiplatelet therapy is maintained at therapeutic levels during surgery. Aspirin is frequently used antiplatelet drugs which belongs to the non-steroidal anti-inflammatory drugs.…”

Section: Introductionmentioning

confidence: 99%

A longitudinal study to evaluate the bleeding pattern of patients on low dose aspirin therapy following dental extraction

Sunu

Roshni

Ummar

et al. 2021

Journal of Family Medicine and Primary Care

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Background and Aims: Antiplatelet dugs are often interrupted preceding invasive dental extraction because of concern of bleeding complications. The fear of uncontrolled bleeding often prompts medical and dental practitioners to stop aspirin intake for 7 to 10 days before any surgical procedure, which puts the patient at risk from adverse thrombotic events. The aim of the study conducted was to evaluate the bleeding pattern after routine dental extraction among patients on low dose long term aspirin therapy. Methods: A total of 104 subjects in the age group of 30-65 years, who continued to have aspirin intake during extraction were included in the study. Dental extraction was performed without stopping aspirin therapy under local anesthesia. The post-operative blood loss was quantified by weighing the gauze pre and post operatively and adding total volume of fluid in the suction jar. Results: Of these 104 patients treated, 87% of patients had mild bleeding (<20 ml) and 13% of patients had moderate bleeding (20-30 ml). The total study population showed a mean blood loss of 16.15 ± 3.5 ml. Conclusion: Within in the limitations, our study concluded that the routine dental extraction in patients under low dose aspirin therapy did not cause clinically significant post extraction hemorrhage. Aspirin intake can be continued during routine dental extraction as post extraction bleeding encountered will be negligible.

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Do antiplatelet drugs increase the risk of bleeding after tooth extraction? A case-crossover study

Cited by 7 publications

References 25 publications

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

Advances in Antiplatelet Therapy for Dentofacial Surgery Patients: Focus on Past and Present Strategies

Do Antiplatelet Drugs Increase the Risk of Bleeding After Dental Implant Surgery? A Case-and-Crossover Study

A longitudinal study to evaluate the bleeding pattern of patients on low dose aspirin therapy following dental extraction

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