From the Guidelines
Aspirin (Acetylsalicylic Acid) should be started within 6 hours after dental surgery, as recommended by the highest quality evidence available 1. The decision to start aspirin after dental surgery is crucial in balancing the risk of bleeding complications and thrombotic events.
- The American College of Cardiology Foundation/American Heart Association task force on practice guidelines recommends initiating aspirin within 6 hours postoperatively if it was not started preoperatively 1.
- This recommendation is based on the evidence that aspirin reduces the occurrence of saphenous vein graft closure and adverse cardiovascular events, with a Level of Evidence: A 1.
- The typical dose for cardiovascular protection is 100 mg to 325 mg daily, and it should be continued indefinitely to reduce the risk of thrombotic events 1.
- It is essential to individualize the decision to start aspirin based on the patient's bleeding risk and the reason for ASA therapy, and to consult with both the dentist and the prescribing physician before making decisions about ASA therapy around dental procedures.
- Aspirin affects platelet function by irreversibly inhibiting cyclooxygenase enzymes, which impairs clotting, but the risk of thrombotic events from discontinuing ASA often outweighs the risk of bleeding complications in patients with cardiovascular disease.
From the Research
Aspirin Use After Dental Surgery
- The use of aspirin after dental surgery is a topic of discussion among medical professionals, with some studies suggesting that it is safe to continue aspirin therapy after surgery 2, 3, 4, 5.
- A study published in 2017 found that patients who continued to take aspirin after dental extraction did not experience any significant increase in bleeding risk compared to those who stopped taking aspirin 72 hours before the procedure 3.
- Another study published in 2018 found that patients taking aspirin, clopidogrel, ticagrelor, or dual antiplatelet therapy experienced acceptable rates of controllable postoperative bleeding after tooth extraction or minor oral surgical procedures 4.
- The American Dental Association recommends that patients should not interrupt their antiplatelet medications, including aspirin, for tooth extractions or minor oral surgery 4.
Timing of Aspirin Use After Dental Surgery
- There is no specific guideline on when to start aspirin after dental surgery, but studies suggest that it is safe to continue aspirin therapy immediately after surgery 2, 3, 4, 5.
- A study published in 2015 found that dental extraction was safe for patients receiving dual antiplatelet therapy, which includes aspirin, when using sutures and gauze impregnated with tranexamic acid 5.
- The decision to start or continue aspirin therapy after dental surgery should be made on an individual basis, taking into account the patient's medical history and the risk of bleeding versus the risk of thrombosis 6.