Warfarin dose advice

I'm having a tooth extraction tomorrow. Have just tested my INR on coaguchek & it has increased to 3.2. Should I stop Warfarin tonight or perhaps just eat a whole lettuce ( ??). Any ideas please! Sandra

[BobD Volunteer]

My dentist doesn't bother these days.

[Dodie117]

I had extraction last year. My dentist seemed to say not a problem at these levels so if it was me I would not stop warfarin but maybe have good portion of spinach or broccoli. Only my opinion !

[Hidden in reply to Dodie117]

Thanks Bob & lallym .... I shall cease worrying forthwith!

Sandra

[Hidden]

Sandra, Just don't have a curry

[Hidden in reply to Hidden]

Koll ...just been out for seafood lunch so curry will not feature tonight!😕

[Bagrat]

My dentist happy with anything under 4.

[Hidden in reply to Bagrat]

Thanks!

[10gingercats]

I would not worry unless you have a history of severe bleeds.....Also your dentist should know enough and be up to date with current guidelines so I would be guided by him.

[dedeottie]

I have had a tooth extraction on 3.2 the dentist was ok with this and just told me to go to A and E if it didn't stop bleeding. As it was, I was fine. It did bleed for significantly longer than before warfarin but not excessively. Just make sure the dentist knows and then he can decide what he is happy with. Good luck.x

[Hidden]

Thanks Dedeottie.....it could be a tricky one as its the root from a snapped off bridge. Have also got two root canals to look forward to as well😢😢😢. Sandra

[Hidden]

My dentist was really grim about this - just for a scaling, he said I had to test between 2 and 2.5 on the day of the appointment (the doctors were very helpful with that thank goodness). With the help of some broccoli I made 2.3, but I think he was being exceptionally severe.

[Hidden in reply to Hidden]

Just tested again & I'm 3.6....oh well, we shall see!

[Hidden]

Just back from dentist. She said there would be a lot of bleeding with INR 3.6. Not good as my haemoglobin levels are low. She prefers INR to be Max 3.0. Poss 3.2. So that's that. Will have to keep close watch on levels before next appointment . Could have been the antibiotics I have been on for chest infection

[ILowe in reply to Hidden]

I am not near my database of articles, but, from memory, any INR less than 4 should be fine, Bleeding can happen even without warfarin, and is easily controlled and almost never serious. The dentist using modern methods should be able to control this, though he might be tougher on you which means the required clot which promotes healing may not form. Google it and show it to your dentist.

[Hidden in reply to ILowe]

Ilowe.. Thank you for your response.

My dentist, although young ( compared to me anyhow ) is highly qualified& I wouldn't dream of telling her how to do her job. After all I am completely at her mercy when she has the drill going!! I have complete confidence in her & she is very gentle. I wouldn't want to upset the status quo!

She was thinking of my overall health as well as I am not ' tip top' at the mo. Practice receptionist tells me that max INR of 3.0 is required by all their dentists.

Regards Sandra

[ILowe in reply to Hidden]

Then your dentists are playing needlessly safe. At this point it is a power decision, not an information decision.

The general trend in the last 20 years is to do more and more operations etc without touching the INR and to accept higher INRs. The least difficult is teeth. I had tooth surgery, not just an extraction. ie the doctor/dentist had to cut the gum, then cut each root which was fused to the jaw. He then packed the hole with antibleeding dressing, and it worked.

I have found, the best way to make experts rethink is to take the latest medical journal articles to them and ask them what they think. The experts are also good at wriggling, but they take this stuff seriously. Sorry I do not have the article to hand.

[dedeottie]

Oh yes you are probably right there.x