Dental work

[brownbear57]

I have root resorption on one of my front teeth, the dentist will have to remove it and either fit an implant or I will have a denture on a plate instead. My GP said I need to stop my warfarin for a day before and two days after and have heparin instead, he said the dentist should arrange this. When I spoke to my dentist about this he said the GP should arrange the injections......to say I'm confused is an understatement , who will arrange my injections? Feeling very uneasy and not at all confident about the whole business, has anyone else had dental work done similar to me? Any advice greatly appreciated, thank you.

[gizmomaven]

I had a tooth removed recently and my dentist told me to keep taking Warfarin and their ruling is as that as long as your INR is between 2-4 then they can do the extraction without stopping Warfarin.

I did check this on the dental medical council website and they confirm this ruling

[Jaileena1957]

I have been on warfarin since 1998, for any extraction, or root canals, my Cardiologist wants me off warfarin for at least 4-5 days, on lovenox injections which I self administer, I hold the lovenox injection 8 hours before the Dental procedure, I immediately restart the warfarin and continue with the injections, until my inr is back in range for me it is 2.5-3.5, I have a mechanical heart valve, I don't know if this makes a difference or not, I would discuss this with your Cardiologist...as always safety first!

[brownbear57 in reply to Jaileena1957]

Thank you for your reply, the reason I take warfarin is for Factor V Leiden so do not see a cardiologist.

[daisyd]

Your GP or anticoagulant clinic are the people who should arrange this and give you advice on how to give yourself the injections

This happened in my case

[brownbear57 in reply to daisyd]

Thanks for your reply but I do not visit an anticoagulant clinic as I self test and self dose my warfarin. My GP has also commented that I know more than him these days!

[greenrob]

I have had 5 different day operations involving some form of cutting.......biopsies and minor invasive surgery in some of the best London hospitals.Conflicting advice from the medical profession as you know

Best advice came from day surgeries in leading hospitals,who have a protocol for this.

1. Get Gp to prescribe a box of self injection syringes for 10 days. with correct dose ,which depends on your weight.

2. Stop taking warfarin 5 days before operation and on 4th day take one injection of heparin no warfarin and do this each day until day before operation .No heparin or warfarin 24 hrs before op.

3.After surgery start taking heparin again after no chance of bleeding .the dentist will advise you. Start warfarin again and take both until your INR reaches 2.(easy if you have a self tester) this may take 5 days.It is ok to take them together because they work in different ways and heparin has no effect on INR.

Some hospital recommend 3 days before stopping .Its all about having little amount of anticoagulant in your system when surgery starts .GPs know little about this ,just get the prescription from them .Good luck.

[brownbear57 in reply to greenrob]

Thanks for your informative reply and good wishes 😀