Is Antiplatelet Therapy a Risk Factor for Extraction of Tooth?

Medical physicians often advise patients on oral antiplatelet therapy to stop or alter their medication before extraction. A review of the available literature shows that there is an increased risk of cardiovascular episodes if medication is altered or discontinued. Hence there is a need to evaluate the risk of bleeding in patients whom antiplatelet therapy is not discontinued before extraction. Aim: To evaluate the risk of bleeding in patients in whom oral antiplatelet therapy is not withdrawn prior to extraction of teeth. Objectives: To evaluate the incidence of intra-operative bleeding. To evaluate the incidence of post-operative bleeding. To evaluate the bleeding profile. Materials and Methods: This is clinical trial of sample size of 100 participants, were equally divided into two groups :Group A –patients in whom oral anti -platelet therapy was stopped prior to extraction and Group B –patients in whom anti-platelet therapy was continued prior to and following extraction . Physician's fitness consent and informed consent from patients were obtained. Intra-alveolar extractions were performed. The risk of bleeding was observed by incidence of bleeding observed at three stages and patients were monitored. The bleeding was graded as mild, moderate & severe according to self-introduced scale. Results: Majority of the patients suffered from mild bleeding (stage I and stage II) which was easily controlled by normal pressure pack. Only 4% patients (stage I) and 18% patients (stage II) required local hemostatic measures. In none of the cases, additional measures were required. Conclusion: There is minimum risk of bleeding in the study group which can be controlled with local measures. However, the patients should be monitored continuously. Oral antiplatelet drug need not be stopped for extraction of teeth.