Dental concern.

[Florence-Nightingale]

Hi everyone just wanted to pick your lovely brains. I have a six monthly dental appointment next week and think I will have to have a filling. I go regularly to the hygienist and dentist have never had to have anything done . My question is does anyone know if the local anaesthetic they give can bring on AF. I am on Apixaban and Bisoprolol and am aware of the bleeding risk. I just need to be prepared.

[Hidden]

It is generally recommended to ask your dentist to use an adrenaline free anaesthetic. It can be difficult to get advice about anticoagulants and dental work. In my case, I had to have a wisdom tooth removed and my dentist felt it was important for the extraction to be carried out by a dental surgeon. Although I was taking Apixaban, the INR Nurse said ask the dentist, the dentist said ask the dental surgeon and she didn’t bother to notify the dental practice. In the end, I checked out the NICE recommendations which said continue medication unless having more than 6 extractions. In the event, I did decide to miss the dose prior to the extraction and the dental surgeon did not use an adrenaline free anaesthetic and the whole thing was over in a flash with no adverse issues and not a lot of bleeding. If I were you, I would ask your dentist!!

Good luck!

[Florence-Nightingale in reply to Hidden]

Thank you Flapjack. I will ask for Adrenaline free anaesthetic.

[BobD Volunteer]

Most modern well trained dentists are not concerned about anticoagulation for a simple extraction my dentist tells me. As far as local anaesthetic goes ask for one without adrenaline as this can trigger events in some people. Never had a problem getting this sorted either for dentistry or the recent skin cancer removal I had. I use warfarin and merely had to make sure my INR was below 3 the day of my surgery.

[Florence-Nightingale in reply to BobD]

Thank you Bob.

[Gowers]

My dentist told me there was no need to stop taking Rivaroxaban before various dental work being done. But, when I went to hospital for steroid injection in spine the consultant wanted me to come off it for week.

[Florence-Nightingale in reply to Gowers]

Thank you Gowers.

[Bettiehough]

I had a front tooth extracted, after I Fainted and fell in the hospital and a Maryland bridge was inserted. I am on Apixaban and had a pacemaker and AvNode ablation. I did not stop Apixaban, had adrenaline free injections which you might need more of to go numb. There were some bleeding which the dentist stopped. I wore a dental appliance for sleep apnoea which I think irritated the wound and woke a few days later with a mouth full of blood. Luckily daughter and retired hubby are my dentists and I went to surgery where hubby stopped the bleeding. He brought home stuff to stop bleeding which he used as I continued to bleed a little bit until it stopped completely. Got a Cpap machine for sleep apnea so that helped too.

[Florence-Nightingale in reply to Bettiehough]

Thanks for your reply . Nice having dentists in the family.

[Hidden]

My dentist uses adrenaline free injection as I went into fast A F after adrenaline one. I continue with my warfarin as usual prior to any surgery....just have to ensure that INR is not over 3

[Florence-Nightingale in reply to Hidden]

Thank you.

[Finvola]

Make sure you discuss this with your dentist beforehand so that s/he is prepared and you can get questions answered. Adrenaline can cause rhythm disturbance in many of us - some more than others. I always ask for adrenaline free injections and then remind my excellent dentist at the beginning of the visit.

I also take Apixaban and have had fillings and extractions without stopping it.

[Jc24]

Thank you all for your comments. Learned quite a lot!

[Florence-Nightingale]

Thank you all for your comments will certainly be asking for Adrenaline free anaesthetic. You really are a hive of information for which I am truly grateful. Wish me luck at the dentist.

[Ianp66]

Learned a lot reading his too, great advice, I have to use non adrenaline injections as, had a couple of new pass out moments when he tried a few years ago with fast tachycardia, but using the non adrenaline I was fine, just take a little more of it to numb properly. Now on apixaban so relieved it looks like that's fine to keep taking.