An evidence summary of the management of the care of patients taking novel oral antiplatelet drugs undergoing dental surgery

BackgroundNovel oral antiplatelet (NOAP) drugs (prasugrel and ticagrelor) have emerged in the past decade to overcome some of the drawbacks of existing medications. Little is known, however, regarding the management of the dental care of patients taking these drugs. The author of this study reviewed the available literature to assess the evidence for the management of the care of patients undergoing dental surgery while taking these medications.MethodsThe author used a rapid review approach to identify clinical and scientific research related to dental surgery performed in patients taking NOAP drugs to produce an evidence summary.ResultsThe author did not identify any dental-related systematic reviews or randomized controlled trials of prasugrel and ticagrelor and found the overall quality of evidence to be poor. Most of the literature consisted of nonstructured review articles and guidance documents based on assumptions from nondental data and expert opinion; recommendations on best practice varied throughout.ConclusionsThe findings from the review of the literature on NOAP drugs varied considerably. Recommendations are based on poor-quality scientific data, and clinical trials are required to establish best evidence–based practice guidance.Practical ImplicationsOwing to the lack of evidence on NOAP drugs for dental procedures, clinicians should base their decisions to prescribe prasugrel and ticagrelor knowing recommendations provided in the literature are either unlikely to have sound scientific backing or may have been derived from extrapolation from other surgical specialties. Clinicians should tread carefully when managing the care of dental patients taking NOAP drugs.