Antiplatelet Management — ORE Part 1 MCQ

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HardHuman Disease & Dental ManagementAntiplatelet ManagementORE Part 1

A patient takes aspirin and clopidogrel following coronary stent placement 4 months ago. They need a non-urgent extraction for a symptom-free retained root. What is the most appropriate management?

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Correct answer: B — Defer extraction until antiplatelet treatment ends

Explanation lettering: D = shown as A · E = shown as B · A = shown as C · B = shown as D · C = shown as E

E is correct. The retained root is symptom-free, so extraction is non-urgent. SDCEP advises delaying non-urgent invasive dental procedures where a patient is receiving a time-limited antiplatelet course; this avoids creating a need to manage an avoidable bleeding risk during dual therapy. B and C are unsafe because the dentist should not interrupt antiplatelet treatment, particularly after recent stenting. D is also wrong: cardiology input is not sought to arrange routine withdrawal for an elective dental extraction. A would be appropriate if extraction were clinically necessary and could not be deferred: SDCEP recommends continuing dual antiplatelet therapy and using local haemostatic measures. The distinction between urgent and non-urgent treatment is therefore decisive.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs: Clinical practice advice, 2nd edition, 2022. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/managing-bleeding-risk/clinical-practice-advice/