Frequency of Post-Operative Bleeding after Dental Extraction among Patients on Chronic Low Dose Aspirin

  • Naseer Ahmed
  • Sunia Gul
  • Eruj Shuja
  • Arsalan Maqbool
  • Wasim Ibrahim
  • Muhammad Adil Asim
Keywords: Dental extraction, Post-extraction bleeding, Aspirin


Introduction: Anti-platelet drugs are widely used for primary and secondary prevention of cardiovascular and cerebrovascular diseases. The purpose of this study was to determine the frequency of post-operative bleeding after dental extraction among patients on chronic low-dose aspirin.

Materials and Methods: This is a descriptive case series in which a total of 378 patients on low-dose aspirin of( 75-100mg) for various cardiovascular causes were included in the study. The duration of the study was from November 2016 to May 2017 total of 6 months.

Results: Out of 378 cases, 247 patients (65.4%) were male while 131 patients (34.6%) were female. The mean age of the patients was calculated as 54.8±13.1 years. Regarding pre-morbid, 127 patients (33.6%) were diabetic and 109 patients (28.9%) were hypertensive. The mean duration of taking aspirin was calculated as 3.5±1.7 years. Post-extraction bleeding was noted in 16 patients (4.2%). This was statistically insignificant i.e p-value >0.005.

Conclusion: We concluded that simple tooth extraction is safe in patients on a long-term maintenance dose of aspirin, without discontinuation of the drug as it doesn’t cause any significant postoperative bleeding.


1. Osafo N, Agyare C, Obiri DD, Antwi AO. Mechanism of action of nonsteroidal anti-inflammatory drugs. Nonsteroidal Anti-Inflammatory Drugs. 2017 Aug 23:1-5.
2. Arif H, Aggarwal S. Salicylic Acid (Aspirin).2018.
3. Jahan SS, Younis M, Gul S, Shah AA, Naaz N. Aspirin intake and significant post extraction bleeding-are they related. Int J Contemporary Med Res. 2018;5(3):C30-3.
4. Nathwani S, Martin K. Exodontia in dual antiplatelet therapy: the evidence. British dental journal. 2016 Mar;220(5):235-8.
5. Raber I, McCarthy CP, Vaduganathan M, Bhatt DL, Wood DA, Cleland JG, Blumenthal RS, McEvoy JW. The rise and fall of aspirin in the primary prevention of cardiovascular disease. The Lancet. 2019 May 25;393(10186):2155-67.
6. Saxena A, Kumar GA, Hiralkar P, Mahajan SB, Rubeena S, Tabasum D, Pandey PR. Evaluation of Post Extraction Bleeding on Aspirin Patient-A Clinical Study. 10.21276/sjm.2019.4.8.4
7. Shenoy A, Panicker P, Vijayan A, George AL. Prospective Comparative Evaluation of Post-extraction Bleeding in Cardiovascular-Compromised Patients with and without Antiplatelet Medications. Journal of Maxillofacial and Oral Surgery. 2019 Dec 7:1-0.
8. Shah A, Shah ST, Shah I, Zia-Ur-Rehman Post extraction bleeding associated with long term maintenance dose of aspirin 75–150 mg. Pakistan Oral Dent J 2012;32:199–202
9. Krishnan B, Prasad GA, Madhan B, Saravanan R, Mote NP, Akilesh R. Post-extraction bleeding complications in patients on uninterrupted dual antiplatelet therapy—a prospective study. Clinical Oral Investigations. 2021 Feb;25(2):507-14.
10. Singh S, Mandal S, Chugh A, Deora S, Jain G, Khan MA, Chugh VK. Clinical Post-operative Bleeding During Minor Oral Surgical Procedure and In Vitro Platelet Aggregation in Patients on Aspirin Therapy: Are they Coherent?. Journal of Maxillofacial and Oral Surgery. 2020 Aug 20:1-6.
11. Royzman D, Recio L, Badovinac RL, Fiorellini J, Goodson M, Howell H, et al. The effect of aspirin intake on bleeding on probing in patients with gingivitis. J Periodontol2004;75:679-84
12. Mroczek A, Bałabuszek K, Radzka A, Fałkowska U, Pawlicka M, Bednarski J. To continue or discontinue aspirin? The risk of perioperative complications. Journal of Education, Health and Sport. 2018 Aug 19;8(8):743-7.
13. Gerstein NS, Albrechtsen CL, Mercado N, Cigarroa JE, Schulman PM. A comprehensive update on aspirin management during noncardiac surgery. Anesthesia & Analgesia. 2020 Oct 1;131(4):1111-23.
14. . Schrodi J, Recio L, Fiorellini J, Howell H, Goodson M, Karimbux N. The effect of aspirin on the periodontal parameter bleeding on probing. J Periodontol2002;73:871-6
15. Hasan S, Akhter M, Khan SH, Sharmin D, Karim MM, Rahman R. Evaluation of post-extraction bleeding in patients taking low dose aspirin. Update Dental College Journal. 2019 Apr 27;9(1):32-6.
16. Verma G. Dental extraction can be performed safely in patients on aspirin therapy: a timely reminder. International Scholarly Research Notices. 2014;2014.
17. Wahl MJ. Antithrombotic drugs in dentistry: stop the interruption. Academy of General Dentistry. 2017 Aug:1-3.
18. Ogle OE, Hernandez AR. Management of patients with hemophilia, anticoagulation, and sickle cell disease. Oral and Maxillofacial Surgery Clinics of North America. 1998 Aug 1;10(3):401-4
19. Sonksen JR, Kong KL, Holder R. Magnitude and time course of impaired primary haemostasis after stopping chronic low and medium dose aspirin in healthy volunteers. British journal of anaesthesia. 1999 Mar 1;82(3):360-5
20. Brennan MT, Valerin MA, Noll JL, Napeñas JJ, Kent ML, Fox PC, Sasser HC, Lockhart PB. Aspirin use and post-operative bleeding from dental extractions. Journal of dental research. 2008 Aug;87(8):740-4
21. Malik AH, Majeed S. Post-surgical bleeding in patients on anti-platelet therapy in minor oral surgical patients-A comparative randomized study.2020
How to Cite
Ahmed N, Gul S, Shuja E, Maqbool A, Ibrahim W, Asim M. Frequency of Post-Operative Bleeding after Dental Extraction among Patients on Chronic Low Dose Aspirin. JRMC [Internet]. 30Jun.2021 [cited 24Sep.2022];25(2):270-4. Available from: