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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Precautions Should Be Taken During Tooth Extraction For A Patient With History Of Bypass Surgery?

hi,,,i got a patient with history of bypass surgery 3 years ago for Angina. NOw he is taking daily dose of aspirin 75mg. Now he requires multiple extractions (20 teeth). As a dentist what precautions should i take and is there any need to discontinue aspirin
Wed, 17 Sep 2014
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Dentist, Oral and Maxillofacial Surgery,  's  Response
Thanks for your query, I have gone through your query.
As far the medical history is concerned, if i am your treating doctor, i would suggest you to get complete blood investigations including BT, CT, PT. I would also suggest you to get INR done. If the INR is normal then only you can go for extraction. You need to consult a cardiac physician and take an opinion. Ealiar school of thought was to stop the aspirin one day before the extraction, but now if the INR is normal, then no need to stop the aspirin.
You should also take prohylactic antibiotics before extraction like amoxicillin. Get the teeth removed in multiple visits, like getting 4-5 teeth removed at a time.
I hope my answer will help you, take care.
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Dentist, Oral and Maxillofacial Surgery,  Dr. Kalyan Banerjee's  Response
yes a lot of precaution you have to take.
discontinue aspirin before 48 hours of extraction with concent of the patient"s cardiologist
do an antibiotic prophylaxis according to AHA recommendation
do your job maintaining all stress management protocol.
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What Precautions Should Be Taken During Tooth Extraction For A Patient With History Of Bypass Surgery?

Thanks for your query, I have gone through your query. As far the medical history is concerned, if i am your treating doctor, i would suggest you to get complete blood investigations including BT, CT, PT. I would also suggest you to get INR done. If the INR is normal then only you can go for extraction. You need to consult a cardiac physician and take an opinion. Ealiar school of thought was to stop the aspirin one day before the extraction, but now if the INR is normal, then no need to stop the aspirin. You should also take prohylactic antibiotics before extraction like amoxicillin. Get the teeth removed in multiple visits, like getting 4-5 teeth removed at a time. I hope my answer will help you, take care.