Antiplatelet Management — ORE Part 1 MCQ

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EasyHuman Disease & Dental ManagementAntiplatelet ManagementORE Part 1

A patient takes clopidogrel 75 mg once daily following a previous transient ischaemic attack. They require extraction of one uncomplicated tooth. According to SDCEP guidance, how should the antiplatelet medication be managed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: D — Continue clopidogrel and use local haemostatic measures

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

**A is correct.** SDCEP recommends treating patients taking a single antiplatelet drug without interrupting it. For clopidogrel, perform the extraction atraumatically, limit the initial treatment area where appropriate, and achieve haemostasis with local measures; suturing and packing should be strongly considered because bleeding can be prolonged. Stopping clopidogrel for either seven days (B) or three days (C) is not recommended and exposes this patient, who has cerebrovascular disease, to avoidable thrombotic risk. There is no SDCEP recommendation to substitute aspirin for clopidogrel (D) or reduce the clopidogrel dose (E) for dental extraction. The relevant management is continuation of prescribed antiplatelet therapy with effective local haemostasis.

Reference: Scottish Dental Clinical Effectiveness Programme. Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd edition, Section 8: Treating a Patient Taking an Antiplatelet Drug(s), 2022. https://www.sdcep.org.uk/media/ypnl2cpz/sdcep-management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs-2nd-edition.pdf