Anti-Clotting Drugs No Danger During Tooth Extraction
September 2, 2009

by Nancy Volkers
InteliHealth News Service

INTELIHEALTH - Millions of Americans take antiplatelet drugs, such as aspirin, to reduce the risks of heart attack and stroke. These drugs prevent platelets in blood from clumping together and forming clots. But they also can increase the risk of uncontrolled bleeding.

Now, Spanish researchers observing patients who had teeth removed have found that many people did not have bleeding problems after their teeth were pulled, even though they were on antiplatelet drugs.

The researchers are with the Navarre Health Service in Spain. They studied 155 people who took antiplatelet drugs. The patients did not discontinue their drugs before the extractions. 26 patients reported that they had bleeding at home 24 hours after the extraction and that it stopped. Many of those patients had multiple teeth extracted. One person had uncontrolled bleeding that required emergency care. No one else in the study had difficulties.

The researchers did see an increased risk for bleeding problems in people who had multiple teeth removed. They recommend that dentists remove no more than three teeth at a time. They also said that only neighboring teeth should be removed during the same visit. This keeps the number of bleeding areas to a minimum.

Besides aspirin, antiplatelet drugs include clopidogrel (Plavix), ticlopidine (Ticlid) and dipyridamole (Persantine). Anticoagulants are a larger group of drugs that includes antiplatelet drugs. There are other drugs that stop blood clots in different ways. Warfarin and heparin are two common ones. These drugs were not examined in this study.

Two guidelines advise against routinely stopping antiplatelet medications before tooth extractions.

The study appears in the August 13 issue of a Spanish journal, Medicina Oral Patologia Oral Y Cirugia Bucal (Oral Medicine, Oral Pathology and Mouth Surgery).