ORAL AND MAXILLOFACIAL SURGERY Antiplatelet therapy and exodontia

Background. This is a review of the management considerations regarding exodontia for patients taking antithrombotic medications that affect platelet function or aggregation. Methods. The authors reviewed the literature, focusing on the indications and mechanisms of antiplatelet therapy and the perioperative management of patients taking these agents who require exodontia or other dentoalveolar surgery. Results. Dentists making management decisions regarding patients taking antiplatelet therapy should consider the patient's risk of experiencing perioperative hemorrhage against the risk of experiencing complications associated with thromboembolic events. The risk of perioperative bleeding complications is low for patients taking single or dual antiplatelet therapy. Intraoperative and postoperative bleeding can be controlled with local hemostatic measures. Conclusion. For patients taking antiplatelet medication, bleeding risk for exodontia is generally lower than the risk of experiencing thromboembolic events owing to cessation of therapy. Practical Implications. Dentists can safely complete exodontia in patients who continue taking antiplatelet therapy. The dentist should consult the patient's prescribing physician before considering altering the patient's antiplatelet therapy regimen.