From the Guidelines
Aspirin should be stopped 5 days before dental surgery to reduce bleeding risk, as recommended by the most recent and highest quality study 1. When considering the management of aspirin before dental surgery, it's crucial to balance the risk of bleeding against the risk of stopping aspirin in patients taking it for cardiovascular protection.
- The decision to stop aspirin should be made on a case-by-case basis, taking into account the type of dental procedure and the patient's individual risk factors.
- For patients at high risk of cardiovascular events, such as those with recent stents or a history of stroke, aspirin should not be stopped without consulting their cardiologist or primary care physician first 1.
- The reason for stopping aspirin 5 days before surgery is that it irreversibly inhibits platelets for their entire lifespan, preventing them from participating in normal clot formation, and new platelets must be produced by the body to restore normal clotting function 1.
- After dental surgery, aspirin can usually be resumed within 24-48 hours once adequate hemostasis is achieved.
- It's essential to inform your dentist about all medications you're taking and follow their specific instructions regarding aspirin management before your procedure.
- The American Family Physician study 1 also suggests stopping aspirin 7-10 days before surgery, but the more recent study from Anaesthesia 1 recommends stopping it 5 days before, which is the preferred approach.
From the Research
Aspirin Cessation Before Dental Surgery
- The optimal time to stop Aspirin (Acetylsalicylic Acid) before dental surgery is a topic of debate, with varying recommendations based on different studies 2, 3, 4, 5, 6.
- A study published in 2005 suggested that Aspirin should be discontinued 5 days before elective surgery, as the bleeding times and platelet function tests normalized within 96 hours and 144 hours, respectively, after stopping Aspirin 3.
- Another study from 2019 recommended stopping Aspirin 7-10 days preoperatively to avoid perioperative bleeding complications in spine surgery patients 5.
- However, a 2014 study found that platelet reactivity normalized 96 hours after Aspirin withdrawal, suggesting that a shorter cessation period may be allowable for dental procedures when appropriate local hemostatic measures are taken 6.
- It is essential to consider the individual patient's risk factors, such as cardiovascular disease, and balance the risks of ceasing Aspirin against its continuation during the perioperative period using a patient-specific strategy 2.