DAPT Dental Extraction — MFDS Part 1 MCQ

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ModerateHuman DiseaseDAPT Dental ExtractionMFDS Part 1

A patient taking dual antiplatelet therapy with aspirin and clopidogrel following coronary stent insertion requires a single uncomplicated dental extraction in primary care. The patient has no additional medical or medication-related risk factors for bleeding. What is the most appropriate management?

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Correct answer: B — Continue both antiplatelet agents and use local haemostatic measures

The correct answer is B. SDCEP recommends treating patients taking single or dual antiplatelet therapy without interrupting their medication. Although aspirin plus clopidogrel can prolong bleeding, clinically significant bleeding after dental treatment is generally controllable with local measures. For dual therapy, initially limit the treatment area—for example, perform one extraction and assess haemostasis—and strongly consider socket packing and suturing. Stopping either or both agents is inappropriate because interruption, particularly after coronary stent insertion, may precipitate a serious thromboembolic or cardiac event. Routine hospital referral is unnecessary for an uncomplicated extraction when the patient has no additional bleeding-risk factors. The guidance's example of three teeth applies to limiting root surface debridement, not to routinely extracting three teeth per visit.

Reference: Scottish Dental Clinical Effectiveness Programme, Management of Dental Patients Taking Anticoagulants or Antiplatelet Drugs, 2nd edition, Section 8: Antiplatelet Drugs, 2022. https://companion.sdcep.org.uk/management-of-dental-patients-taking-anticoagulants-or-antiplatelet-drugs/treatment-recommendations/antiplatelet-drugs/