Pharmacology · single question
Same patient on Clopidogrel and Aspirin — what modification is needed for dental treatment?
Show answer and explanation
Correct answer: A. No modifications needed for routine dental procedures
No modifications needed for routine dental procedures (A). Current evidence and guidelines (ADA, AHA) indicate that routine dental procedures (extractions, scaling, restorations) can be safely performed in patients taking antiplatelet therapy WITHOUT stopping the medications.
• The risk of stopping antiplatelet therapy (thrombosis, stent thrombosis, MI, stroke) OUTWEIGHS the risk of minor dental bleeding that can be managed with local hemostatic measures.
• Local hemostatic measures: pressure, sutures, resorbable gelatin sponge (Gelfoam), oxidized cellulose, tranexamic acid mouthwash, fibrin glue.
• Exception: For complex oral surgery with high bleeding risk, consultation with the prescribing physician is recommended, but discontinuation is rarely warranted.
• Never stop antiplatelet therapy without physician consultation.
• The risk of stopping antiplatelet therapy (thrombosis, stent thrombosis, MI, stroke) OUTWEIGHS the risk of minor dental bleeding that can be managed with local hemostatic measures.
• Local hemostatic measures: pressure, sutures, resorbable gelatin sponge (Gelfoam), oxidized cellulose, tranexamic acid mouthwash, fibrin glue.
• Exception: For complex oral surgery with high bleeding risk, consultation with the prescribing physician is recommended, but discontinuation is rarely warranted.
• Never stop antiplatelet therapy without physician consultation.