Harvard Heart Letter

No need to stop aspirin, Plavix before tooth removal

A procedure as simple as having a tooth pulled can pose problems for someone on aspirin plus clopidogrel (Plavix). Taking this combination for at least a year is a must for everyone who has had a drug-coated stent implanted during artery-opening angioplasty. Aspirin plus Plavix helps prevent blood clots from forming inside a stent, which can cause a heart attack or cardiac arrest.

One downside of this combination is that it interferes with the formation of blood clots when they are needed, such as after surgery or after having a tooth removed. Some surgeons and dentists prefer that their patients stop taking the drugs a week or so before the procedure. But this temporarily boosts the chances a clot could form inside the stent.

Greek researchers studied 643 men and women having one or two teeth pulled. The standard technique for stopping bleeding after extraction — biting down on a pad of gauze for 30 minutes — worked in almost everyone taking aspirin or Plavix.

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