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Oral Surgery · single question

A patient taking clopidogrel and aspirin (81mg) needs a tooth extraction. What modification is needed?

  1. No modification necessary — proceed with local hemostatic measures
  2. Consult physician and discontinue clopidogrel only
  3. Prescribe fresh frozen plasma before procedure
  4. Discontinue both antiplatelet agents 5–7 days before
Show answer and explanation

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

  • A. Correct. Current ADA and cardiology guidelines support CONTINUING dual antiplatelet therapy for routine extractions. Bleeding is managed with LOCAL hemostatic measures (pressure, gelatin sponge, sutures, tranexamic acid rinse).
  • B. Incorrect. Selectively stopping clopidogrel is also generally not recommended for routine extractions without specialist input.
  • C. Incorrect. FFP is a hospital intervention for major coagulopathies — not appropriate for routine dental extraction.
  • D. Incorrect. Discontinuing antiplatelet therapy before dental extractions is NOT recommended. The thromboembolic risk (stroke, MI) of stopping these medications exceeds the hemorrhage risk of routine dental extraction.

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