title: No evidence for stopping long-term aspirin therapy before tooth extraction.
abstract: METHODS
  PubMed, ScienceDirect and EBSCOhost databases.
  
  
  METHODS
  Prospective randomised controlled trials (RCTs) or controlled trials.
  
  
  METHODS
  Two independent investigators extracted data. The primary measured outcomes were rates of haemorrhage and bleeding time. Disagreements were clarified with a third investigator. Relevant authors were contacted if any relevant data was missing. The Grades of Recommendation, Assessment, Development and Evaluation (GRADE) system was used to evaluate the overall quality of evidence. The authors used standardised mean difference or relative risk to evaluate each outcome.
  
  
  RESULTS
  Ten studies were included, three randomised controlled trials and seven controlled trials. A total of 1752 patients were enrolled in the meta-analysis; the study group comprised 529 patients on long-term aspirin therapy, and the control group comprised 1223 patients. The risk of post-operative haemorrhage was significantly higher in patients on aspirin therapy (relative risk=2.46; 95% confidence interval: 1.45-4.81) but bleeding time was not significantly different between the two groups (standardised mean difference=0.63; 95% CI: - 0.04 to 1.31).
  
  
  CONCLUSIONS
  Increased rates of haemorrhage are observed in patients on long-term aspirin therapy. The authors recommend not stopping long-term aspirin prior to dental extraction, and local measures for haemostasis should be enhanced when required.
authors.affiliation: Dublin Dental University Hospital, Dublin, Ireland.
authors.forename: Daphne
authors.initials: D
authors.lastname: Halley
authors.affiliation: Dublin Dental University Hospital, Dublin, Ireland.
authors.forename: Robert
authors.initials: R
authors.lastname: Weld-Moore
authors.affiliation: Dublin Dental University Hospital, Dublin, Ireland.
authors.forename: Brett
authors.initials: B
authors.lastname: Duane
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D055094:Evidence-Based Dentistry; D006488:Hemostasis, Surgical; D006801:Humans; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D019106:Postoperative Hemorrhage / Q000209:etiology* / Q000517:prevention & control*; D014081:Tooth Extraction; D028761:Withholding Treatment
chemical_list: D010975:Platelet Aggregation Inhibitors; D001241:Aspirin