I agree with Dr. Olin that the study sample was relatively small. However, as mentioned repeatedly in the article, this is only a preliminary report and is the first report checking the influence of stopping aspirin in patients undergoing oral surgery.
Only in this way can we prove the efficiency of any treatment modality, even if this is a well-established treatment, as Dr. Olin mentioned. Every change must begin somewhere. This article is only the beginning. [In the future,] we hope to research a study group in the hundreds. Afterwards, we will publish our results.
Regarding the risk of not stopping aspirin, we believe that the thromboembolic complications carry a higher morbidity rate than continuing the medication.
Studies already have shown that in patients taking warfarin that bleeding control using local methods has no effect systemically on the patients (
Gaspar R, Brenner B, Ardekian L, Peled M, Laufer D. Use of tranexamic acid mouthwash to prevent postoperative bleeding in oral surgery patients on oral anticoagulant medication. Quintessence Int 1997;28[6]:375–9[Medline]
;
Sindet-Pedersen S, Ramstrom G, Bernvil S, Blomback M. Hemostatic effect of tranexamic acid mouthwash in anticoagulant-treated patients undergoing oral surgery. N Engl J Med 1989;320[13]:840–3[Abstract]
).
I would like to remind Dr. Olin that bleeding caused by aspirin is mainly intraoperative, and bleeding time is the only measurement for this. Since we found bleeding time within normal limits, we are certain that hemostasis will occur during the surgical procedure.
In conclusion, we would like to thank Dr. Olin again for raising this question, but our dealing with this subject is very legitimate and of utmost importance for improving our practice.
