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ADC Practice Question — Antiplatelet therapy and dental procedures

coronary stent was placed 4 months ago. What is the…

Pharmacology questions in the ADC written exam test applied prescribing decisions, not rote recall of drug names. This exam-level vignette tests your ability to work through clinical details and arrive at the correct management.

Mr. David Chen, a 58-year-old man, presents urgently on a Saturday morning with severe pain from a lower right wisdom tooth. He had a coronary artery stent placed 4 months ago and takes warfarin plus aspirin 100 mg daily. His cardiologist has advised he must remain on both medications. He has an INR of 3.0 from Friday's blood test. Clinical examination reveals a partially erupted tooth 48 with pericoronitis and localised swelling but no trismus or systemic signs of infection. The coronary stent was placed 4 months ago. What is the significance of this timing for dental management?

  • A. The coronary stent is an indication for infective endocarditis prophylaxis before any dental procedure
  • B. Dental treatment is permanently contraindicated in patients with coronary stents
  • C. Elective dental treatment should be deferred for 12 months after stent placement
  • D. Elective dental procedures are contraindicated within 6 months of stent placement, but emergency treatment for pain and infection should still be provided
  • E. There is no significance; stent patients can receive normal dental treatment at any time
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Sources cited
Therapeutic Guidelines v4 Odell's 3rd & 4th Ed IADT 2020 Code of Conduct CMS (Evans) Infection Control + more
Show the answer and cited explanation
Correct answer: D

According to TG, elective dental procedures are contraindicated within 6 months of stent placement, MI, CABG, or valve procedure. If emergency dental treatment is needed within this window, it should be provided but adrenaline-containing local anaesthetics should be avoided. TG states a coronary stent is NOT an indication for IE prophylaxis.

Source: Ch 23: Defer elective dental 6 months post-stent; emergency treatment permitted
Remy's study tip — For pharmacology vignettes, read the patient’s medical history and allergies BEFORE looking at the drug options.

Exam preparation FAQ

Should I memorise guidelines word-for-word for Antiplatelet therapy and dental procedures?
Focus on decision points — when the guideline says X vs Y. The exam tests application, not recitation.
How are Antiplatelet therapy and dental procedures questions structured in the ADC written exam?
ADC Antiplatelet therapy and dental procedures questions present as clinical vignettes requiring management decisions. The correct answer is always traceable to a guideline source.

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