Abstract
Purpose
This research aims to study the effects of low-dose aspirin on bleeding after exodontia and to compare statistically and analyze perioperative blood loss during exodontia in patients on aspirin therapy and healthy patients and also to discuss the various measures if required necessary for controlling postoperative bleeding in simple and uncomplicated exodontia.
Materials and Methods
The study included 100 patients, ranging in age from 30 to 60 years. The patients were divided into two groups, a test group consisting of 50 patients who were on a daily dose of 75–150 mg of aspirin and a control group consisting of 50 patients not on any antiplatelet therapy. All extraction procedures were performed on outpatient basis. Patients were operated under local anesthesia. Post-extraction sockets were checked for bleeding immediately (30 min) and followed up at 24, 48, and 72 h, and 1 week, after the procedure.
Results
Amount of intraoperative blood loss was similar in both test and control groups, and there was no excessive postoperative bleeding in any case. Out of 100 patients, only three patients of test group and two patients of control group required level II hemostatic measures and two patients of test group needed level III measures.
Conclusion
We could reach a conclusion and recommend that patients on long-term low-dose aspirin (75–150 mg) need not to discontinue their aspirin dose prior to routine exodontia and can be carried out safely with enhanced local hemostatic measures, if required.
Similar content being viewed by others
References
Medeiros FB, de de Andrade ACP et al (2011) Bleeding evaluation during single tooth extraction in patients with coronary artery disease and acetylsalicylic acid therapy suspension: a prospective, double-blinded, and randomized study. J Oral Maxillofac Surg 69:2949–2955
Blinder D, Manor Y, Martinowitz U, Taicher S (1999) Dental extractions in patients maintained on continued oral anticoagulant. Comparison of local hemostatic modalities. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 88(137):40
Devani P, Lavery KM, Howell CJT (1998) Dental extractions in patients on warfarin: is alteration of anticoagulant regime necessary. Br J Oral Maxillofac Surg 36:107–111
Aframian DJ, Lalla RV, Peterson DE (2007) Management of dental patients taking common hemostasis-altering medications. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 103(Supplement 1):S45e1–S45e11
Duygu G, Ozcakir-Tomruk C, Guler N, Sencift K (2010) Assessment of effects of antiplatelet drugs on bleeding risk after teeth extractions. Biotechnol Biotechnol Equip 24(3):2040–2043
Ardekian L, Gaspar R, Peled M, Brener B, Laufer D (2000) Does low-dose aspirin therapy complicate oral surgical procedures? J Am Dent Assoc 131(3):331–335
Can MM, Biteker M, Babur G, Ozveren O, Serebruany VL (2012) Knowledge, attitude and perception of antiplatelet therapy among dentists in Central Eastern Turkey. World J Cardiol 4(7):226–230
Lemkin SR, Billesdon JE, Davee JS, Leake DL, Kattlove HE (1974) Aspirin-induced oral bleeding: correction with platelet transfusion. A reminder. Oral Surg Oral Med Oral Pathol 37:498–501
McGaul T (1978) Postoperative bleeding caused by aspirin. J Dent 6:207–209
Thomason JM, Seymour RA, Murphy P, Brigham KM, Jones P (1997) Aspirin-induced post-gingivectomy haemorrhage: a timely reminder. J Clin Periodontol 24:136–138
Hirsh J, Guyatt G, Albers GW, Harrington R, Schünemann HJ (2008) Executive summary: American College of Chest Physicians evidence-based clinical practice guidelines (8th edition). Chest J 133(6, supplement):71S
Lippert S, Gutschik E (1994) Views of cardiac-valve prosthesis patients and their dentists on anticoagulation therapy. Scand J Dent Res 102(3):168–171
Martinowitz U, Mazar AL, Taicher S et al (1990) Dental extraction for patients on oral anticoagulant therapy. Oral Surg Oral Med Oral Pathol 70(3):274–277
Evans IL, Sayers MS, Gibbons AJ, Price G, Snooks H, Sugar AW (2002) Can warfarin be continued during dental extraction? Results of a randomized controlled trial. Br J Oral Maxillofac Surg 40(3):248–252
Madan GA, Madan SG, Madan G, Madan AD (2005) Minor oral surgery without stopping daily low-dose aspirin therapy: a study of 51 patients. J Oral Maxillofac Surg 63:1262–1265
Brennan MT, Wynn RL, Miller CS (2007) Aspirin and bleeding in dentistry: an update and recommendations. Oral Surg Oral Med Oral Pathol Oral Radiol Endodontol 104(3):316–323
Antithrombotic Trialists’ Collaboration (2002) Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324(7329):71–86
Dalen JE (2006) Aspirin to prevent heart attack and stroke: What’s the right dose? Am J Med 119(3):198–202
Karsh ED et al (2011) Comparison of the effects of warfarin and heparin on bleeding caused by dental extraction: a clinical study. J Oral Maxillofac Surg 69:2500–2507
Partridge CG, Campbell JH, Alvarado F (2008) The effect of platelet-altering medications on bleeding from minor oral surgery procedures. J Oral Maxillofac Surg 66:93–97
Hemelik M, Wahl G, Kessler B (2006) Tooth extraction under medication with acetylsalicylic acid. Mund-Kiefer- und Gesichtschirurgie 10(1):3–6
Morimoto Y, Niwa H, Minematsu K (2008) Hemostatic management of tooth extractions in patients on oral antithrombotic therapy. J Oral Maxillofac Surg 66(1):51–57
Krishnan B, Shenoy NA, Alexander M (2008) Exodontia and antiplatelet therapy. J Oral Maxillofac Surg 66:2063–2066
Cardona-Tortajada F, Sainz-Gómez E, Figuerido-Garmendia J, Lirón de Robles-Adsuar A (2009) Dental extractions in patients on antiplatelet therapy. A study conducted by the Oral Health Department of the Navarre Health Service (Spain). Med Oral Patol Oral Cir Bucal 14(11):e588–e592
Garnier J, Truchot F, Quero J et al (2007) Antiagregant plaquettaire et chirurgie buccale: a propos de 218 extractions dentaires. Rev Stomatol Chir Maxillo-Fac 108(5):407–410
Girotra C, Padhye M, Mandlik G, Dabir CA, Gite M, Dhonnar R, Pandhi V, Vandekar M (2014) Assessment of the risk of hemorrhage and its control following minor oral surgical procedures in patients on anti-platelet therapy: a prospective study. Int J Oral Maxillofac Surg 43:99–106
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
None.
Rights and permissions
About this article
Cite this article
Gupta, R., Dugal, A., Sane, V.D. et al. Effect of Low-Dose Aspirin on Bleeding Following Exodontia: A Prospective Clinical Study. J. Maxillofac. Oral Surg. 17, 350–355 (2018). https://doi.org/10.1007/s12663-017-1034-7
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12663-017-1034-7