Dentist

[Chrisja]

Hi, I need to have a tooth extracted. My dentist said there is no decay but I have'lost bone' so the nerve is exposed.Also xray showed a tooth still in the gum, next to it, that she advised should come out at the same time. She would not do it herself due to me taking an anticoagulant. She offered to refer me to the hospital, which she said had a 12 week waiting list. I'm not in pain with it, just hot and cold sensitivity,so I could wait. I was thinking of trying to find a more experienced dentist locally that could do it privately. BTW I am 80 but fairly fit except for Afib, but I do have episodes very often. I feel a bit daunted goin g to Hospital for treatment and would much rather just go to the dentist. Do you think it would be more sensible to just bite the bullet and go to Hospital, do you think it would be safer. I can't make up my mind. Thanks for any comments or advice. Christine

[Hidden]

Hi Chrisja, I had to have a wisdom tooth extracted in the spring and my dentist wanted a dental surgeon to do it because of concerns about anticoagulation. It meant waiting 4 weeks and that was not very pleasant, 2 lots of antibiotics etc etc. I was not told to stop taking my apixaban, but I did decide to miss the morning dose and it was all a bit of a non event with very little bleeding. I may be wrong, but I get the feeling that some dentists prefer to not get involved and would rather shove the problem onto someone else, no doubt they would argue that it is safer to have it done somewhere that is better equipped to deal with all eventualities. I suggest you ask your dentist if they can recommend a Dental Surgeon or perhaps ask at other practices nearby but I suspect it would have to be done privately, Pardon the pun, but if you are not in pain, maybe biting the bullet and having it done at hospital maybe the best option. Good luck, hope you soon get it resolved.......

[Chrisja in reply to Hidden]

Thanks flapjack, there is a very good private practise near me. I think I will just pop in to the surgery and see what they have to say. Might help me come to a decision. I have noticed when I cut myself slightly i don't seem to bleed much,so I agree with your comment of the bleeding aspect being a bit of a non event. Thanks again. Chtistine

[BobD Volunteer]

I agree with most of what Flapjack said. NHS dentists in particular would rather not trouble themselves with people on anticoagulation. My private dentist has no such worries nor needs me to stop taking them. The only thing I would say is that ideally you need a local injection without adrenaline which might otherwise trigger your AF so please discuss this with whoever you decide to see.

[Chrisja in reply to BobD]

Thanks BobD, When I see the private dentist,if he is happy to do it and seems confident,then I will go along with that. If not I will go to the hosp. Either way I won't forget about the injection that must be without adrenaline. Thankyou for that. Christine

[Dodie117 in reply to Chrisja]

Sounds like a sensible decision/compromise. My NHS dentist recently removed a wisdom tooth and I did not come off apixaban. I adjusted my timing slightly (my own idea) so I was at the lowest level on the 12 hour spectrum. No bleeding and all fine. However tooth had shallow root and was a bit loose so dentist was very confident that there would not be a problem.

[Wightbaby]

I am in PAF and recently had a wisdom tooth removed by my private dentist - he had no qualms whatsoever and did it there and then without me making a further appointment! I was a bit shocked when he said "I will do it now!!"

Unfortunately, this was the day before my INR check due, and I hadn't had them checked for 6 weeks...the longest I have ever gone between checks!!

It did bleed rather a lot but he soon rectified this with a stitch....next day when i had my INR's checked they were 3.3...so not exactly surprising. He should have waited and checked they were in range I feel, but hey ho, no harm done!!

[Bagrat in reply to Wightbaby]

My dentist says as long as INR under 4 no worries. I know people with artificial vakves may have to maintain INR at between 3 and four with no concerns.

[Chrisja]

Hi Wightbaby, Thanks for your reply. Your dentist sounds very relaxed about the whole thing. My dentist made me nervous,she looked quite horrified when I told her I was on rivaroxoban. I feel more comfortable with it now. As you say maybe he should have checked before he went ahead,but he obviously knew what he was doing, and stopped the bleeding by putting in a stitch. Thank you Christine

[Hidden]

I think I would prefer to wait and hsve it done in hospital .12 weeks is not that long if its not bothering you.

I've had quite a bit of treatment in past 2 years from my private dentist....extractions , crowns and root canals but was referred to hospital some years back for a tricky extraction of a back tooth. I think the dentist at the time was a bit worried about doing it as I had previously gone into AF after an adrenaline based injection . I had very good treatment in hospital with several attendants if I recall correctly !

[10gingercats]

You might also want to check out if your hospital dental dept., has a cancellation lius. My husband did this and was seen within days rather than waiting for 3 months .They gave him half a days notice.....so rang at 9 a.m for a 2p.m slot.

[Jeanette49]

I live in Spain, and my dentist had similar concerns, and wanted an assurance from a cardiologist that I should stop taking the rivaroxaban 2 days prior to the extractions. Apparently these anti coagulants do not affect your INR in any way, they aren’t blood thinners so I have been told from many members here. Anyway, I had the 2 large back teeth, 1 each side, removed (no adrenaline) last week, packed with sponges containing anti bleeding properties, stitched and no more bleeding than usual. I had to go back the next day so he could check, he was very pleased, they were already starting to heal, and no bleeding overnight either ( I had the extractions at 7pm)

Good luck and hope you find a solution x