Clopidogrel Dental Extraction — MFDS Part 1 MCQ

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ModerateHuman DiseaseClopidogrel Dental ExtractionMFDS Part 1

A patient taking clopidogrel monotherapy requires one uncomplicated dental extraction. They have no additional medication or medical condition that increases bleeding risk. What is the most appropriate perioperative management?

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Correct answer: A — Continue clopidogrel and achieve haemostasis using local measures

The correct answer is A. SDCEP recommends treating patients taking single or dual antiplatelet drugs without interrupting their medication because cessation exposes them to potentially serious thromboembolic events. For a patient taking clopidogrel, bleeding may be prolonged, so sufficient treatment time should be allowed and haemostasis secured using local measures; packing and suturing should be strongly considered. A single extraction appropriately limits the initial treatment area. Stopping clopidogrel for 7 days or omitting a dose is not recommended for routine dental extraction. Bridging with low molecular weight heparin does not reproduce clopidogrel's antiplatelet protection and is inappropriate. Prophylactic platelet transfusion is not indicated for an elective uncomplicated extraction.

Reference: Scottish Dental Clinical Effectiveness Programme (SDCEP), Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, Antiplatelet drugs section, 2nd edition, 2022. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/antiplatelet-drugs/