Antithrombotic drugs up bleeding risk after tooth extraction

Antithrombotic drugs may lead to greater bleeding after tooth extraction, a recent study has found. Such an effect is modified by oral hygiene, age, and the number of extracted teeth.

Researchers conducted a retrospective case-control study including 200 patients who had undergone tooth extractions, half of whom were on antithrombotic drugs. Postoperative bleeding was defined as the oozing or marked haemorrhage following mechanical compression with a gauze for 30 minutes.

Bleeding events occurred in 27 percent and 9 percent of patients who were given antithrombotic medication and controls, respectively (p<0.01). Relative volume of bleeding was likewise greater in patients taking antithrombotic drugs (p=0.028).

The researchers then performed logistic regression analysis to identify potential risk factors for postextraction bleeding in patients taking antithrombotic medications. Adjusting for confounders revealed that age (odds ratio [OR], 2.824, 95 percent confidence interval [CI], 1.073–7.434; p=0.036) and the number of extracted teeth (OR, 5.268, 95 percent CI, 1.358–20.437) increased the likelihood of bleeding events.

Despite such elevations in risk, the overall prevalence of bleeding remained relatively low. “The present study provided clinical evidence to support the consensus that it is safe and feasible for patients taking anticoagulant and antiplatelet drugs to perform tooth extraction without stopping the drug,” the researchers said.

“Of course, prospective experiments with a larger sample size are needed to further explore the risk factors of tooth extraction bleeding in anticoagulant patients,” they added.