Tooth extraction on Rivaroxaban - dentist won't do it!

Yesterday I went to my dentist with what I thought was a lost filling and was told sadly that I have an infected tooth and the options are extraction or root canal treatment which came as a horrible shock as that is the only top molar I have to chew on. As I am a very nervous patient and have to have adrenaline free injections my dentist seemed to favour extraction but she said because I am on Rivaroxaban I would have to go to hospital for it! Oh no, I said, I just have to stop it for a day, no problem. So she consulted the practice clinical director and confirmed what she said. She said Rivaroxaban is different to other blood thinners (presumably because irreversible) and the medication instructions are against doing extractions while taking it, also they had a patient who ended up in hospital 8 hours later. I guess they are scared of being sued. I've looked at other posts about teeth and clearly they are being overcautious. Upshot is she is going to try the root canal but in case I freak out or it does not work she is going to refer me to the hospital anyway.

Has anyone else come across this situation?

21 Replies

  • My dentist said stop rivaoxaban for a day before extraction treatment. I insisted on adrenaline free anaesthetic. All was fine. Good luck.

  • Can you get referred to a 'consultant dentist'? I'm not sure what the proper term is but in Northern Ireland we have specialist dentists who treat difficult cases on the NHS by referral from a family dentist. I had a potentially difficult extraction done without stopping Apixaban by being referred to one.

    I suspect my (then) dentist was also afraid of the situation and any consequences - more like she washed her hands of me.

  • I suppose that is who I would see in hospital? Hopefully the hospital will advise them re safety precautions.

  • That is very interesting. I'm on warfarin but hope to change to rivaroxaban in the new year. I've had 3 root canals this year ...staying on warfarin. Dentist told me that root canal treatment could not be done in hospital, at least in this area..west Sussex.

    Some years ago I had a very difficult extraction done in hospital ...very traumatic .....and ended up being admitted with AF and subsequent DCCV a few days later.

    Would be interested to hear how you get on. I'm also very nervous about root canal treatment !


  • The dentist will do the root canal but not the extraction. I've had root canal on a front tooth but not a molar......

  • You should stay on rivaroxaban without a break.

    As it is your last one my opinion is root canal is definitely the best option. I've had 4 or 5 over the years.

  • Bear in mind that the adrenalin free injections have a very short acting period, so be prepared to have more than one injection for a lengthy dental procedure.

  • I expect so, fortunately I have a high pain threshold which is not always a good thing but on this occasion maybe. I am not afraid of pain, it is the waterboarding I don't like!

  • Hi x just had 2 extractions in hospital a couple of weeks ago. I was told to take rivaroxaban as usual. ..I did at 5pm the night previous and had the teeth out at 9am next day and was fine. But the would not use adrenaline free..I bleated but they still refused..said it wss against their guidelines. To be honest I was that much in pain and high as a kite on Tramadol I let them do it.....luckily I was ok but if I had have gone into af I would have made a complaint and told them of this....nicely of course as she has a needle in her hand!!!!

    One really good thing is it's free in hospital. ..I was elated as was expecting to pay x Good luck x x x

  • How long did you have to wait for the appointment at the hospital?

  • Sorry just seen the message..was about 6/8 weeks x x

  • That is a problem if you are in pain.

  • I too had a tooth that was root canal or extraxtion. I chose extraction as i was told root canal was not a permanent treatment and possibly only last a year. I was taking Apixiban and just stopped for the morning. Check with your doctor but i see no reason for the hospital, unless your dentist is wary of being sued if things went wrong. After my extraction i went for an ablation which was stopped due to finding a clot in my heart. Your dentist maybe reluctant becsuse of the infection, my tooth was not infected just broken off. Hope this helps

  • I'm surprised that you were told that a root canal treatment was not permanent. I have had several,most a number of years ago, and had no problems with any of them. It is essential that all traces of infection are removed before the canal is filled but provided this is done this should be a permanent solution.

  • I don't really know. It was a molar, and he said that all the bad part of the tooth could not be removed as i was a very large filling. The was no tooth left on the top only the root and a crown would be pegged on to it. So maybe this was why as i am now 73yrs old.

  • Why is root canal not permanent?

    I've had some for many years

  • Sometimes I'm glad I'm on warfarin. As long as INR between 2 and 4 our dentist wil do extractions. Husband also on warfarin had two last week - one on each side - no probs but as he's in permanent AF I think he got the adrenaline +local.

  • Had a tooth extraction, they stopped my xarelto 3. Days prior, no problem, just had knee surgery and they did the same thing. No problems

    Of course I didn't know to ask for adrenaline free shot at the dentist and they put me back into afib.

  • I had to have been on rivaroxaban for at least two months before they would do Cryoablation. I'm sure they are being cautious.

  • I've been told by my heart specialist that I should stop 2 days before an extraction. Unfortunately, no dentist seems to want to perform an extraction.

    I have to wait a couple of weeks for a specialist to do it. I can't wait that long, as I did so before, the infection spread, I lost 2 good teeth, and, spent 5 days in hospital.

  • 😱

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