Hello all,
I am due a dental appointment next week, and I'm getting very nervous because this will be my first since I started on Apixoban (blood thinner).
I have a very dodgy tooth that is due extraction - has anyone had a tooth out whilst on a thinner - was it done at the surgery, or is it a hospital job and how did it go?
I'm really very worried 😢.
Babs x
Hi,
There are instructions for dentists online on the NICE guidance website. I had a canine root extraction while on Apixaban and there was no bleeding at all. I think if you are having several teeth out at once the guidance differs about stopping but be guided by your dentist. Everyone who has discussed this on here has been fine!!
Hi,
Thank you for your reply, I really appreciate it😊.
I have the awful feeling my dentist will refer me to the hospital, which will mean a very long wait, I suffer with AF and I think she will be too nervous to touch me.
its all a nightmare - oh for being in good health and normal again..
Babs x
If you look up and print out the NICE guidance it should put her mind at rest that she can treat you herself.
Hi Brummiegal 
have you informed your dental practice of a change of medication, I did I told them about taking an anticoagulant and beta blockers because it can affect a number of things including the kind of anaesthetic you are given.
You might find this up to date article of interest ...
ncbi.nlm.nih.gov/pubmed/293...
If you are worried I would have a chat with a both your doctor and your dentist.
I think NOACS are still so new a proper procedure for their comprehensive use has still to be decided..
Hello, and thank you for your reply. This AF and the medications that go with it make me feel like a ticking time bomb😞 My GP surgery haven't been very supportive since I was diagnosed last July, I always leave there feeling more confused and isolated in my condition than when I went in. I have told my dental surgery about the Eliquis (Apixaban) and Beta blocker but I will double check when I go in.
Thanks again.
Babs x
Good luck with the dentist Babs I have had a similar experience with the GP.
If ever you need a bit of support from fellow AFers this is the place to come
Hi Doodle68,
Thank you so much for responding, I don't know what I would have done over the last 12 months without this site and the great people on here. The advice and insight I have been given money couldn't buy. I am so grateful.
Babs x
Hi, I have to have an extraction (very broken tooth with a calcified root so a bit complicated?) but my dental surgery has a policy of referring all extractions for people on NOACs to hospital which means a long wait. I t seems they had a bad outcome with a patient so not taking any chances. I think it all depends on your own surgery's policy.
Hi Buffafly, I have no doubt they will refer me to the hospital - I have found that Afib and Blood thinners don't make people feel very comfortable.
I have waited nearly 12 months for a referral to a heart clinic, so Lord knows how long the queue is for the Dental Hospital and treatment.
Thanks for your support.
Babs xx
I had a large back tooth taken whilst taking Apixaban. In line with the protocol for anticoagulated patients at the dentist's surgery, I had the extraction at 8.15am, the dentist observed the socket for 15 minutes, packed it with haemostatic gauze and put in a couple of stitches. I took my normal Apixaban dose at 9.30am and had no problems at all - just the normal pink oozing. I had the extraction done with non-adrenaline anaesthetic and had no arrhythmia problems either. I was 72 at the time, by the way - spring chicken.
Make sure your dentist knows the details of all your medications, your AF and other arrhythmias and discusses all aspects of the treatment beforehand. Try not to worry, an informed dentist is usually a safe dentist.
Hello Finvola,
Thank you for your very comforting message, it has made me feel easier about it all.
I have no doubt though that they will refer me to the hospital, the Dental practice here hardly have time for generalised treatment they have so many patients to treat, so they won't be happy about clogging up the production line with me I'm afraid.
As I Said earlier the waiting lists here in wales are extraordinary long, so this tooth will have no doubt rotted in my gum by the time I get there. - sorry to sound so derogatory, but since I was diagnosed with AF last year it has been one nightmare situation after another .
Many thanks again ❤ x
Babs x
I was referred to a dental consultant’s practice on the NHS and had to wait only about 10 days - hospital in N Ireland would have been months too. Best wishes with it.
Thanks Finvola, I am feeling more positive about it all now, thanks to all of you wonderful supportive people on this site.
Babs x
Make sure your dentist knows and that you need non adrenaline local injection in case the adrenaline sets off your AF. This is important.
Hello BobD,
Thank you so much for responding, I will make sure they know all the ins and outs - nothing is straightforward these days, it seems to be one crisis after another - I have even wondered on occasion whether it is all worth it, if I honest. The only support I have ever had has been on these forums. All my questions and concerns just seem to be pushed to one side or fobbed over at my Drs surgery, they just don't see interested at all - just going by the book and through the required motions, so they can tick the right boxes and hurry me - and many others - out of surgery.
As I mentioned on other posts I have waited nearly 12 months for a referral to the heart clinic, I haven't never seen a Cardiologist for consultation, I was diagnosed AF in Resus A&E last July 1st 2017 called in for an echo cardiogram 6 weeks later, I was rung by the receptionist at the Drs surgery and told the result of 'No further action required' - when I asked what happens now she said keep taking the tablets - I made an appt to see a GP, explained it all to him and he said ' you are one of the lucky ones Barbara - you don't have heart failure or heart disease so be happy with your lot - I don't feel very lucky when my heart starts racing off for no apparent reason and starts doing the rumba, or when I lay awake at night frightened half to death because of what's happening to me - I don't feel very lucky at all😢.
I had to ask 3 different Drs at surgery before one of them agreed that questions needed answering and I finally got referred - that was 4 months ago and I finally have an appt at the end of July - with a Cardiology Dr not a Consultant ( but I will take whatever I can get at this point) - I am hoping for a 24hr monitor so I can show them what is happening to me - whenever I get checked over at surgery my readings are always fine and I feel like a fraud and then later or the next day I am in a blind panic because my hearts bouncing around like a trainer in the tumble drier,and I'm terrified I will end up in hospital.
I am so very sorry I have tangled and moaned on - please forgive me, It just helps to get it off my chest.
Babs x
Sorry - predicted text - should read rambled on 😊 x
Sound off all you want Babs. Nothing we haven't been through I'm sure. It is so disappointing when you encounter doctors like that and unless you know NICE guidelines and can put them straight it can be a hard slog. I was lucky in 2004 when I moved down to Devon as after ten years of my GP looking in the wrong direction with completely incorrect diagnosis my new GP had a mother with AF who actually understood the problem and fast tracked me to cardiology and then later to an EP.
Hi again BobD,
Funny you should mention Devon - I'm moving down later this year, and hopefully being back in England I will have better luck with health care than I do here - all I can do is hope.
I think my main problem if I'm completely honest is that until last year I had managed to keep illness at bay except that I was diagnosed with GAD ( Generalised Anxiety Disorder in 2009 and told I would need to take the meds on a long term basis, maybe for life.
I took myself off my medication in March of last year, I was feeling fine, no panic attacks, no 'End of the World' feelings nothing at all, so I thought it was time. Then the stress and reality of my Son moving to Exeter to live and work and the lonliness that prevailed took my Anxiety levels to a new height, and I had that awful night in A&E because of it all - and got myself diagnosed as AF given a bag of meds and sent home - not having had a chance to talk to a Cardilogist since then has left me frustrated as well.
I am hoping that this appointment at the heart clinic will help to sort everything out. My Echo was clear, I;m hoping that other tests will come back clear as well, then I can ask for my Anxiety meds back instead of the heart meds I am taking at the moment.
Babs x
We have a nice place to live and the pace of life is a little slower down yere. I'm in north Devon but do get over to Exeter for support group meetings run by CDreamer
Babs, I felt just like you at the beginning - something which was so serious to me seemed to cause a minor blip on the systems looking after me, with long waiting times and overworked staff.
The wonderful thing about this forum is that you learn to support yourself - the treatment to seek, how to go about that, what is ‘normal’, what may be a crisis and how to move on with life.
I go out from the assumption that it is a normal circumstance of life to have a health condition, to take drugs for that condition and to expect health professionals to have protocols and methods to deal with me effectively when I need them. It does help mentally with some of the stress.
Please don’t hope for a 24 hour monitor - ask for one and expect them to agree. Confidence sometimes filters through the red tape!
Thank you - I will ask and not hope - It never was me to be a 'Victim' in the past, I always managed to find a positive side to things that happened, but over the last year it has all changed - When it comes to this AF Demon I am a quivering submissive wreck, and it has got to stop, It is ruining me and my life, and having a knock on effect on my Son and Husband - and that's not fair on them.
It makes it worse with the AF that I have pulsatory tinnitus, so i can hear every beat and change in my heart rhythm - I've tried to look at it positively - I don't need to take my pulse manually, just count against the clock and bobs your uncle - but when it races or bounces about its a curse, because I cant walk away from it, it constantly reminds me that something's wrong.
I need a distraction - but what - any ideas?
Babs x
Tinnitus seems to be a problem with many of us - mine isn't too bad and is noticeable only when I lie on my side. There are quite a few posts about it if you search using the box on the top right. Some people find music a distraction and I notice one person had white noise suggested to him. Hope you find some relief.
If your AF is reliable and will oblige for a 24 hour monitor, fine. If it doesn't, you may do better with an event monitor which would enable you to record some of an episode when it happens.
Constant monitors are useful to indicate if people are having AF and not noticing it, but at the other end of the scale, one can have a monitor for 7 days (which can be tediously itchy) and nothing to show for it. Pocket event monitors can be used just when AF is happening and I think some GP surgeries make them available for a week or two.
I had two teeth out while taking Warfarin. Never had any problems. Dentist asked me lots of questions before he took them out. I had to show him my card with INR results.
Have no fears. I had three molars out when on Apixiban. No trouble at all.
I am having a dental extraction and dental implant in 2 weeks time. I am having an early appointment at the dentist and not taking my morning apixaban then taking the medication a few hours later. The dentist has written to my gp for approval.
BobD is right: avoiding adrenaline, which is easily done. I also insisted that I gagged easily, so please help me. He did -- injecting in different places, and the assistant took more care to stop the spray touching my throat. I told him I had a high pain threshold, and would prefer more pain and less drugs. We agreed a hand signal when it hurt, so that he knew, and could decide to keep going or not.
Mine was worse than a simple molar removal: it was jaw surgery, to cut out three roots that had fused with the jaw. All done in outpatients without changing anticoagulation.
Frankly, the main problems are after the surgery. The techniques used to reduce bleeding also hinder some of the natural healing. It is natural for a plug of blood to form and consolidate at the bottom of the socket. This plug formation is hindered, which, I am sorry to say, can mean greater pain afterwards. Then, because we cannot take many of the pain medicines, we have few options. For over two weeks I lived with pain which stiffened neck muscles into a seemingly permanent cramp. The pain went down when I worked so I became a workaholic for a few weeks. The main feature that kept me going was that this pain is normal, natural, and not at all dangerous, and that it does pass.
A few years later, gum healing has made good progress and I can even bite on it.
I've had extractions whilst on apixaban, which I continued, with no problems.
Anti coagulants or blood thinners?
Blood thinners
Apixaban and dental treatment.
Are blood thinners necessary 
Dental treatment on Apixaban
