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AF Association
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A fib episode/tooth extraction

Hi, I would like to know whether anyone has had a tooth extracted while having an A fib episode? I have at last got a Hospital appointment after 8 months of waiting. I usually have an 'episode' between 10 and 14 days apart,they last approx. 12 hours. I had one last night and it made me think 'what if' this happened on the day of my appointment,would I be able to go ahead? I can't bear the thought of waiting such a long time to get another one. I would be grateful for any replies. Thank you. Christine

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It depends on whether or not you have a GA and then depends on the anaesthetist as it is they who will be looking after you. Waiting that long I assume it is a wisdom tooth?

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Hi Bob D, its a large back tooth that is the problem. I’m having an injection not G A. The reason it’s taking so long is that I waited 6 months for my first appointment. Then they found no apparent decay, but it was very sensitive. So they thought I might manage with desensitising it, as it was important to retain if poss. As it anchored my partial denture. I had CT scan that revealed decay inside the tooth. So this is what has taken so long. I just need to get on with it now.Thanks so much for your reply. Christine

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In that case just make sure that you tell them about your AF and ask for non adrenaline injection which is less likely to trigger an event. Sympathise as I have so few left and need my anchors!

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I had extractions and just told them no adrenaline in the injection, which they did and had no problems at all...

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Hi BobD, thanks for your advice....I shall do exactly as you say. Fingers crossed that it all works out. Christine

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Hi Chryseliz, Just my experience: I'm in the US, am 74, am in permanent a-fib with a pacemaker and ablation just as I was at extraction time. About 2 years ago I needed two top back teeth with unfixable broken crowns removed. I wanted nitrous oxide as I am a dental 'fraidy cat.' As I was on Coumadin at the time I told my dentist my history, he called my Electrophysiologist, and the two of them came up with a treatment plan; It involved 'yes' to the nitrous, they agreed that my INR the day of extractions should be at 2.0. As I did my own testing at home the electrophysiologist gave me a plan to drop the INR down to the required 2.0 over a period of several days. I was allowed post op opoid pain med for 5 days afterward. This worked well and everything went fine. My suggestion is have your dentist work directly with your cardiologist and together devise a specific plan for you to follow before, during, and immediately after your extraction. If one of your docs doesn't want to be involved in shared treatment I would try to find someone who would work together with all 3 of you so you have the best outcome. I hope all goes well and smoothly for you. Even if you are not having an A-fib episode the day of your extraction, there will be a plan in place just in case. Take care. irina

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Thank you Irina, I already have a date for the extraction (a couple of weeks off yet) but I was so worried that I might be in A fib on that day and it might not be possible to get it done. I have waited so long for this appointment....the thought of joining the end of the queue again is impossible. It seems from the replies I have, that it won't be a problem after all. Christine

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Hi Chryseliz-- Just because a tooth has decay in it doesn't mean you have to lose it nowadays! Couldn't you have a root canal to save the tooth, if it is needed to anchor your dentures? Removing it is quite drastic. Unfortunately the NHS won't/can't do complex dental work even in dental hospitals, you would have to pay privately for that. I went private for a complex root canal treatment which took 7 hours over two appointments. The endontologist who did the work said the NHS just won't pay for complex work. My regular NHS dentist was very apologetic and told me the only thing he could do would be to extract the tooth. Might be worthwhile considering going private, if it's important to keep the tooth. It was expensive though. Good luck with whatever you decide.

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Thanks so much for your reply. I have had a hard job deciding what to do. I finally arranged to have the tooth removed. If after that, the denture Doesn’t function, I shall have to think again. Maybe an implant or two?? Thanks again. dizzielizzie1. Christine

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Hi

I had my wisdom tooth out 4 weeks ago in hospital under local anaesthetic. I am in permanent AF which didn't cause any problems. I stopped apixaban 24 hours before and after.

All the best.

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Thank you Marion62 that really helps. I am on Apixaban but the dentist said he will take the tooth out without stopping the Apxiaban dose. Its not a wisdom tooth,just a large back tooth so fingers crossed all will be fine. Christine

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I had a wisdom tooth out at hospital; it was a couple of months after my ablation and I was in NSR. The dentist wasnt keen on non-adrenaline injections, he said the adrenaline holds it to the tooth. It took a while to get the tooth out, it was quite painful after the anaesthetic wore off, and I had to go back to have it repacked a couple of days later. I had a few AF episodes, not sure whether they were triggered by pain, stress or the anaesthetic, but it all settled down nicely after a few days.

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Thank you for your reply JonMiosh. The tooth I'm having out is not a wisdom tooth.So hopefully won't be so difficult to take out. I just wondered what the procedure is if the patient is actually in A fib when they arrive for treatment. Fingers crossed it will work out.Christine

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They wont know you are in afib unless you tell them. If you feel well enough, everything will be fine. Most dentists now dont even ask you to stop anticoagulation

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Thanks John, my thoughts exactly. I’ve been told that I don’t have to stop coagulation. So hope all will go well. Christine

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