title: Bleeding after tooth extraction in patients taking aspirin and clopidogrel (Plavix®) compared with healthy controls.
abstract: The risk of perioperative bleeding is high in patients who take aspirin and clopidogrel after a percutaneous coronary intervention, and whether to stop the drugs is a matter of concern for dentists. The aim of this study was to answer the specific question: should aspirin and clopidogrel bisulphate (Plavix®) be discontinued during a conventional forceps extraction? We studied 64 patients during the first year after percutaneous insertion of coronary stents who were taking aspirin (ASA) 80mg and clopidogrel (Plavix(®)) 75mg, and 50 healthy patients who were to have a conventional forceps extraction at this polyclinic in 2013-2014 and acted as controls. Clinical details (underlying diseases; number of roots; type of tooth; type of haemostasis; and bleeding immediately, 30minutes, and 48hours after intervention) were compared. We evaluated 114 patients with the mean (range) age of 56 (43-76) years, and there were no significant differences in demographic data, underlying diseases, type of tooth, number of roots, and dose of anaesthetic between the groups. There were also no significant differences in the number of bleeds immediately and 30minutes after intervention (P=0.310 and 0.205). The time that the last dose of aspirin had been taken correlated with 30-minute haemostasis (20 compared with 12hours, p=0.037). During the 48hours after the intervention, there were no uncontrolled bleeds or emergency referrals. We conclude that using aspirin and Plavix® simultaneously has no considerable effect on the risk of bleeding in patients having conventional forceps extraction of a single tooth.
authors.affiliation: Atherosclerosis Research Center, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.
authors.forename: Mohsen
authors.initials: M
authors.lastname: Sadeghi-Ghahrody
authors.affiliation: Atherosclerosis Research Center, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.
authors.forename: Seyed Hamid
authors.initials: SH
authors.lastname: Yousefi-Malekshah
authors.affiliation: Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran. Electronic address: dr.karimih@yahoo.com.
authors.forename: Hamidreza
authors.initials: H
authors.lastname: Karimi-Sari
authors.affiliation: Atherosclerosis Research Center, Faculty of Medicine, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.
authors.forename: Hamid
authors.initials: H
authors.lastname: Yazdanpanah
authors.affiliation: Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.
authors.forename: Mohammad Saeid
authors.initials: MS
authors.lastname: Rezaee-Zavareh
authors.affiliation: Students' Research Committee, Baqiyatallah University of Medical Sciences, Tehran, IR-Iran.
authors.forename: Mohammadhosein
authors.initials: M
authors.lastname: Yavarahmadi
mesh_terms: D001241:Aspirin / Q000009:adverse effects*; D000077144:Clopidogrel; D004359:Drug Therapy, Combination; D006801:Humans; D006472:Oral Hemorrhage / Q000139:chemically induced*; D010975:Platelet Aggregation Inhibitors / Q000009:adverse effects*; D013988:Ticlopidine / Q000009:adverse effects / Q000031:analogs & derivatives*; D014081:Tooth Extraction
chemical_list: D010975:Platelet Aggregation Inhibitors; D000077144:Clopidogrel; D013988:Ticlopidine; D001241:Aspirin
keywords: Aspirin; Clopidogrel; Tooth extraction; Uncontrolled bleeding