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Apixaban and tooth extraction

I had a filling at the dentist last week as I had broken a piece of my tooth. Dentist said If it didn't work I might need a crown or tooth out, it is my back tooth. He also said if I needed to get it out I would need to go to hospital for the extraction because of Apixaban. Over the weekend it has been painful although it feels like it is the one next to the one he filled. If I have to go back, would he have to refer me to hospital, I worry how long it will take as it is painful, also would I have to stop Apixaban. Would be grateful to hear from anyone on Apixaban who has had to have an extraction, did you have to stop Apixaban and for how long, did it bleed a lot and did you have to stay In Hospital? I know I am being silly but I am really frightened of dentists and hated having the filling, he said just a scratch but it did really hurt!! Thanks for any help, king regards, Heather

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Heather most dentists these days are happy to do dental work including extraction whilst the patient is on anti-coagulation so it sounds a bit as if your dentist is being over cautious. I have noted this sort of problem a few times for some members whilst others have had no problems at all.,

Whatever happens the general consensus would seem to suggest that stopping the night before was adequate should the operating dentist so require. Do remember that should you have a local injection at any time then you need to ask for non adrenaline as the normal one with adrenaline may trigger AF in some patients.

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Interestingly Bob, I asked my "oral surgeon" about non adrenaline injections and she said that because they were far less effective, they needed to inject much larger amounts and that in her view, they could be more of a problem. She used the normal stuff and all was OK, but I guess it raises an interesting question????

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This happened to me in March this year. I too am on Apixaban.I had an 'overlay'...better than a crown.....less drilling and allows for a crown later if the overlay should break.With a crown first go off you then have to have the tooth out as the tooth has to be reduced to gum level for a crown.....BUT overlays are v. expensive.I was in no way persuaded to have it done.Had a v. long talk with dentist before I decided on the overlay.

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I had a similar experience with a new dentist. She referred me to a consultant dentist for the extraction of a large back tooth. I was advised to take my Apixaban the night before as usual. My appointment was at 8am, the socket was packed with haemostatic (sp?) gauze, two stitches and I was observed for 15 minutes - no problems and I took my normal Apixaban at 9am. I too was terrified as I had awful toothache at the time. But, it was a doddle. Home for breakfast.

As for the referral, speak to your dentist and don't allow him/her to do what mine did - she referred me by second class post! Needless to say, I changed my dentist.

Remember to discuss adrenaline free anaesthetic with the hospital. Best wishes.

PS - sorry, forgot to say I had only normal oozing from the socket for a short time.

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Thanks for replies, looks like I will have to go to hospital if I need extraction. I will take all your advice and get adrenaline free injection and ask for quick referral if needed, regards Heather

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Definitely recommend non adrenaline injections. ....found them very effective anyway. Many years ago I had a normal injection which sent me into frighteningly fast heart rhythm......think dentist at the time was just as frightened !!

I've had lots of dental work over past 2 years...on warfarin...and no problem with bleeding . My dentist is a whizz with extractions....done in a flash.

Sandra

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Hi gemsmum, I can only tell you about my recent experience when I had a wisdom extracted a month or so ago. My dentist does not do extractions, these are normally carried out by an "oral surgeon" who visits the practice once a month.....how impressive is that!!

Like you, I'm on apixaban and found it difficult to get advice on what to do. The arrythmia nurse told me to speak the INR nurse who told me to speak to the dentist who unfortunately, did not respond to my request. The advice I got via the internet was that for 1 to 3 extractions you should not stop taking your anticoagulant. For extractions in excess of 3, miss the dose before the appointment but take the following one. In my case, I was in NSR and had been for sometime so I opted to miss the morning dose. The actual extraction was a bit of a non event, over in minutes, fortunately the blighter came out whole. Bleeding stopped quite quickly but you must not rinse your mouth for at least 24 hours. With hindsight, I should probably not have missed the dose. The only other issue was about 5 days later I developed heavy bruising around my throat and neck which subsided in about 10 days. Because I was going abroad the day after it appeared, I did have it checked at A&E just in case it was something more sinister.....bit long winded, but it was not a problem....hope it helps.

PS do you know any good dentists in Surrey coz mine is ****!!!

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Thanks for helpful reply, my dentist is in Lancashire so no help to you but probably wouldn't recommend anyway regards Heather

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you will be fine Heather......best of luck, John

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I would be very grateful if you could let me know which dentist you used in Portimao. We are going to Alvor in August, I know which hospital to use if needed in Alvor and would feel better if I knew a dentist as well. As I am sure you know Alvor is close to Portimao and we do hire a car, thanks again, Heather

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Delighted to Heather, the manager of our hotel recommended him as he had used him for many years. He was excellent and the practice was very well equipped and reasonably priced.

Dr Roy Rodrigues, RoyalDente, Av. do Brasil which is close to the large Continente supermarket and shopping complex in Portimao.

royaldente.pt

We like Alvor very much so have a lovely time and if you like it, please keep it to yourself!!!!!.......best wishes....John

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Thanks for info, much appreciated. This is our sixth time to Alvor we love it, twice last year, thankfully never needed hospital for AF or dentist, hopefully will not this year either, Heather

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If you don't mind travelling to west London, Peter Kertesz is superb. Only needed 2 injections in 20 years. Pain and drug free expertise for fillings and crowns.

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Hi

I had a canine root extracted two weeks ago- it was very difficult- took over an hour!! It didn't bleed at all. I delayed the morning dose of Apixaban and took it after the extraction when it was obvious there wasn't any bleeding. The dentist knew about Apixaban and avoided cutting into the gun to help with the extraction- no problems at all

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Hello Heather, I have recently had a number 6 crown and the underlying tooth extracted. I was given a local anaesthetic. The procedure took 20 minutes. I had 3 stitches. I am also on apixaban. I did not stop taking my medication. There was a small amount of blood. There was also a small amount of bruising and swelling. I went home after the procedure. The bruising and swelling lasted a few days. The stitches were self dissolving. The whole procedure was a total success. I advise you to stop worrying.

Regards, dml.

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I feel you pain I'm waiting for apmt at dental hospital after my dentist referred me for an extraction I am on Rivaroxaban. I too scared about dentist but more happy to be out of pain. Sorry doesn't answer your question but good luck

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