Combination of aspirin and clopidogrel for the prevention of thrombosis: implications for the dental practitioner.
The use of aspirin and clopidogrel as effective antiplatelet therapy in preventing secondary thromboembolic events is well-established. However, there is controversy among dentists and physicians regarding the appropriate dental management of patients receiving dual antiplatelet therapy due to the lack of clinical studies about hemorrhagic risk in these patients. Indications for modifying dual antiplatelet therapy--whether it is done by altering doses, switching to monotherapy, or discontinuing it completely--occur infrequently, as most patients can be treated in a dental office setting. In all cases, patients must be managed jointly by the dentist and physician, taking into account the patient's medical and dental history. This article reviews the current use of aspirin and clopidogrel as combination therapy, examining their effect on platelet function, the associated hemorrhagic risk during dental procedures for patients using this therapy, and how oral health care providers can manage these patients safely and effectively.
Shah
Paulomi R
PR
Department of Oral Health Sciences, University of Kentucky College of Dentistry, Lexington, USA.
Yepes
Juan F
JF
Valenza
John A
JA
D001241:Aspirin / Q000627:therapeutic use*; D001792:Blood Platelets / Q000187:drug effects; D000077144:Clopidogrel; D017742:Dental Care for Chronically Ill / Q000379:methods*; D004359:Drug Therapy, Combination; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000627:therapeutic use*; D013927:Thrombosis / Q000188:drug therapy* / Q000517:prevention & control; D013988:Ticlopidine / Q000031:analogs & derivatives* / Q000627:therapeutic use
D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin