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Should we stop aspirin before dental extraction?

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aspirin AND dental extraction

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guideline aspirin dental extraction continue antiplatelet therapy

Usually, do not stop low-dose aspirin before a routine dental extraction. Continuing it causes at most manageable local bleeding in most cases, while stopping it can raise the risk of heart attack, stroke, or stent thrombosis in people taking it for cardiovascular prevention. The [ADA guidance](https

Quick answer

Usually no. For a routine simple dental extraction, aspirin is generally continued, because bleeding can usually be controlled locally with pressure, sutures, and hemostatic materials, whereas stopping aspirin can increase the risk of a clot, heart attack, stroke, or stent thrombosis.
Do not stop it on your own. The dentist should know:
  • why you take aspirin
  • your dose
  • whether you also take clopidogrel, ticagrelor, warfarin, apixaban, etc.
  • any history of a recent heart attack, stroke, or coronary stent
If you take aspirin after a stent or for prior heart attack/stroke, the dentist should contact the prescribing clinician or cardiologist before considering any interruption.

What if I also take clopidogrel or a blood thinner?

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dental extraction AND anticoagulants

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ADA dental procedures clopidogrel anticoagulants DOACs tooth extraction guidance

For a simple extraction, the usual approach is still not to stop medication yourself, but the dentist must plan it with the prescriber when you are on more than aspirin alone.
  • Aspirin + clopidogrel (dual antiplatelet therapy): Often continued for routine dental extractions. This is especially important if prescribed after a coronary stent, heart attack, or stroke, because interrupting either drug can cause a dangerous clot. The dentist should contact your cardiologist or prescribing clinician before any change. The ADA advice generally supports not altering antiplatelet therapy for dental procedures, using local bleeding control instead.
  • Warfarin: Simple extraction is often done without stopping warfarin if the INR is within the agreed therapeutic/safe range. The dentist may request a recent INR, particularly if several teeth or a surgical extraction is planned.
  • DOACs such as apixaban, rivaroxaban, dabigatran, or edoxaban: A single uncomplicated extraction often needs no interruption. For multiple, surgical, or higher-bleeding-risk extractions, the dentist and prescriber may advise timing the procedure around the dose or omitting/delaying one dose. Do not make that adjustment independently. The SDCEP dental guidance recommends no interruption for low-risk procedures, with individualized dose timing for higher-risk work.
  • Injection anticoagulants such as enoxaparin, or a combination of an anticoagulant plus aspirin/clopidogrel: this needs direct prescriber input before extraction.
Tell the dentist every medicine and dose, why you take it, kidney/liver disease, prior abnormal bleeding, and whether you had a stent or clot recently. They can reduce risk by doing fewer teeth at one visit and using pressure, sutures, local hemostatic material, and sometimes tranexamic acid.
Seek urgent dental or medical help if bleeding remains heavy despite firm gauze pressure for 30 to 60 minutes, repeatedly fills the mouth with blood, or you feel faint.
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