Should aspirin be stopped before tooth extraction? A meta-analysis.

Area of Science:

• Oral Surgery
• Pharmacology
• Evidence-Based Dentistry

Background:

• Aspirin is commonly used for its antiplatelet effects.
• The decision to stop aspirin before dental procedures like tooth extraction is debated.
• Understanding aspirin's impact on bleeding is crucial for patient safety.

Purpose of the Study:

• To meta-analyze evidence on aspirin use and bleeding complications during tooth extraction.
• To determine if aspirin cessation is necessary before dental surgery.

Main Methods:

• Systematic search of PubMed, ScienceDirect, EBSCOhost, and Science Citation Index databases.
• Inclusion of randomized controlled trials (RCTs) and controlled nonrandomized trials up to September 2014.
• Meta-analysis of data from 1752 patients (529 on aspirin, 1223 not on aspirin).

Main Results:

• Aspirin therapy significantly increased the risk of postoperative hemorrhage (RR = 2.46).
• No significant difference in bleeding time (BT) was observed between groups (SMD = 0.63).
• Sensitivity analyses indicated unstable results.

Conclusions:

• Long-term aspirin use may prolong bleeding or exacerbate hemorrhage.
• Discontinuation of aspirin before tooth extraction is not recommended.
• Enhancing hemostasis techniques is a preferred strategy for managing bleeding risk.