The frequency of bleeding complications after invasive dental treatment in patients receiving single and dual antiplatelet therapy.
BACKGROUND
The dental literature suggests that a patient's antiplatelet medication schedule should not be altered before invasive dental procedures. The authors conducted a study to examine the frequency of bleeding complications after invasive dental procedures in patients taking antiplatelet medications.


METHODS
In a retrospective study of 43 dental patients who were receiving single or dual antiplatelet therapy, the authors conducted a chart review of patient records and examining documentation of the medical history. They collected demographic data; medical history; medication history; social history; presence of preoperative infection at any dental visit as evidenced by swelling, purulence or periapical radiolucency; number and type of invasive dental visits; emergency department visits; types of dental procedures performed; use of adjunctive perioperative local hemostatic measures (for example, topical thrombin, absorbable gelatin compressed sponge, sutures); blood products used preoperatively and postoperatively; and postoperative complications.


RESULTS
Twenty-nine patients (67 percent) were receiving dual antiplatelet therapy. There were 88 invasive-procedure visits consisting of extractions, periodontal surgery, and subgingival scaling and root planing. The authors found no differences between patients receiving single or dual antiplatelet therapy for all variables, most notably the number of invasive-procedure visits, total extractions and adjunctive hemostatic measures. There were no documented episodes of prolonged postoperative bleeding.


CONCLUSIONS
The frequency of oral bleeding complications after invasive dental procedures was low to negligible for patients who were receiving single or dual antiplatelet therapy.


CONCLUSIONS
The risks of altering or discontinuing use of antiplatelet medications far outweigh the low risk of postoperative oral bleeding complications resulting from dental procedures.
Napeñas
Joel J
JJ
General Practice Residency, Department of Oral Medicine, Carolinas Medical Center, P.O. Box 32861, Charlotte, N.C. 28232, USA. joel.napenas@carolinashealthcare.org
Hong
Catherine H L
CH
Brennan
Michael T
MT
Furney
Scott L
SL
Fox
Philip C
PC
Lockhart
Peter B
PB
D000543:Alveoloplasty / Q000009:adverse effects; D001803:Blood Transfusion; D003029:Coagulants / Q000627:therapeutic use; D015331:Cohort Studies; D015921:Dental Implants / Q000009:adverse effects; D012534:Dental Scaling / Q000009:adverse effects; D004632:Emergency Medical Services; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000627:therapeutic use; D006490:Hemostatics / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008875:Middle Aged; D006472:Oral Hemorrhage / Q000209:etiology*; D019647:Oral Surgical Procedures / Q000009:adverse effects*; D010483:Periapical Diseases / Q000382:microbiology; D010510:Periodontal Diseases / Q000601:surgery / Q000628:therapy; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology; D012189:Retrospective Studies; D016745:Root Planing / Q000009:adverse effects; D013537:Sutures; D013917:Thrombin / Q000627:therapeutic use; D014076:Tooth Diseases / Q000382:microbiology; D014081:Tooth Extraction / Q000009:adverse effects
D003029:Coagulants; D015921:Dental Implants; D006490:Hemostatics; D010975:Platelet Aggregation Inhibitors; D013917:Thrombin