A patient taking both aspirin and clopidogrel requires a routine single-tooth extraction. What modification to the medication is required?

Correct answer: A. No modification — proceed with local haemostatic measures

• A. CORRECT. Current evidence and consensus guidance are clear: DO NOT INTERRUPT antiplatelet therapy for routine dental extractions. Bleeding is reliably managed locally, whereas withdrawal carries a real risk of thrombotic catastrophe — stent thrombosis, myocardial infarction, stroke. Proceed with atraumatic technique, sutures, an oxidised cellulose or gelatin sponge in the socket, firm gauze pressure and tranexamic acid mouthwash if needed.
• B. Stopping both compounds the risk without meaningful benefit.
• C. Stopping clopidogrel is the specific danger. Dual antiplatelet therapy usually means a recent coronary stent, and premature cessation of the P2Y12 inhibitor is associated with stent thrombosis, which carries high mortality.
• D. Stopping aspirin alone is likewise unnecessary and increases cardiovascular risk.

Note: The governing principle across anticoagulants and antiplatelets alike: local haemostasis is highly effective and a bleed is manageable, whereas a thrombotic event may not be. Any decision to alter therapy belongs to the prescribing physician, not the dentist — and for routine dental surgery that decision is almost always to continue.