Apixaban

[Kingsley09]

I have to go to the dentist tomorrow and may have to have a tooth out and am a bit worried about if I bleed a lot I don’t bleed when I clean my teeth or have any bruising since I’ve been on it 2 yrs but this is the first time that I’ve had a problem with my teeth so am a bit concerned was wondering how anyone else has been having dental work done

[Hidden]

At our dentist, we always have to book a second appointment if a procedure is necessary. If it is the same with you, the dentist will advise about the apixaban.

If a procedure is normally done the the same day, the dentist may go ahead anyway.

Best check with the staff what she prefers.

Edit : you might ask what she does about adrenaline in the local anaesthetic, with you having AF

[Hidden]

Hi Kingsley, suggest you google the NICE recommendation regarding anticoagulation and dental work. From memory, it suggest that you carry on with your medication as normal for anything up to 4 extractions! In my case, I had a wisdom tooth removed last year and found it impossible to get information from the dentist, the Arrhythmia Nurse and my old INR nurse so I missed the dose before the extraction and carried on as normal after. No problems. We are not medically trained, but as I understand it the risk of stroke is miniscule by missing one dose of Apixaban......

[Finvola]

Firstly, make sure your dentist knows your up to date medication, will discuss the extraction with you and knows about the possibility if your needing a non-adrenaline injection. Some of us have heart reaction to adrenaline - others not.

I take Apixaban and had a large extraction without any problems. My dentist sees anticoagulated patients early in the day - 8.15am in my case. I simply delayed taking my dose for an hour or so that morning. (Probably wasn’t necessary). Dentist observed socket for 15minutes after extraction, packed it with dissolving haemostatic gauze and put in a couple of stitches. All I noticed was the usual pinky oozing for the first day.

Best wishes.

[Dodie117]

I had extraction whilst on apixaban and no problems.

[radagast58]

I think the risks of bleeding with warfarin and the DOACS needs to be put in perspective. Both delay blood clotting but don't in any way "thin the blood." Relatively minor bleeding from procedures such as dentistry shouldn't present problems as pressure can be readily applied until clotting occurs and haemostatic gauze can also be used. Obviously the extraction site needs to be observed for further bleeding and if this is severe medical advice would be required but this is no different to an extraction without anticoagulants.

The real risks are from massive internal haemorrhage such as can result from a head injury when this would be a life threatening medical/surgical emergency!

[betsea]

I had a tooth pulled with on Eliquis with no bleeding problems. If you are worried stop the blood thinner the day before.

[Kingsley09 in reply to betsea]

I saw my dentist and she has referred me to the hospital to have it taken out just in case I bleed badly don’t know how long I will have to wait