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When reviewing the medical histories of adult patients, clinicians are likely to find many who are taking aspirin to prevent cardiac incidents, and some taking aspirin because they have already had a cardiac incident. Some patients receive monitoring by physicians, while many do not.
According to General Dentistry, the results of a study done in 2001 (Catella-Lawson) indicated that the positive effects of an aspirin regimen are counteracted by ibuprofen taken for pain relief. When ibuprofen (for pain relief) was taken before aspirin, the cardio-protective effects of aspirin were blocked. A report released in 2003 followed over 7,000 cardiac patients who registered with their physicians between 1989 and 1997; 6,285 took aspirin alone, 187 took aspirin and ibuprofen, and the remaining 528 took aspirin and diclofenac or another NSAID. The patients taking aspirin and ibuprofen had a much higher risk of mortality than those taking aspirin alone. Subsequent studies have indicated a possible interaction between the ibuprofen and aspirin, though retrospective data is inconclusive. A study of veterans who received their medications at the Durham Veterans Affairs Medical Center Pharmacy between 1990 and 2000 matched patients who received aspirin alone and those who received aspirin and ibuprofen. When cardiac infarctions were counted based on medication history, there was no statistical difference and no greater risk between the 2 groups.
Ibuprofen used in dentistry is generally a short-term situation. However, if there are alternative pain relievers, and the patient is amenable to their use, it might be wise to suggest them until there is more conclusive research.
(Source: General Dentistry, January-February 2006)
