Tooth extraction and apixaban

[Caradomben]

Hi just wondering if anyone has had experience of dental extraction whilst on Apixaban and when their anticoagulant was withheld .

[Finvola]

I’ve had two separate extractions without stopping my Apixaban. The second one was an unplanned difficult extraction of a lower wisdom tooth done several hours after I had taken my morning dose (which worried me more than the pain!).

Neither gave problems, bleeding was normal with pink oozing for the first 24 hours. For the first planned extraction, I had it done first thing in the morning and took my dose an hour late.

In both cases I made sure to have adrenalin free injections - these can be less effective and adrenalin holds the anaesthetic in the tissues for longer. I found them to be fine - no pain and no excess bleeding.

Hope it goes OK for you.

PS - I would need a lot of persuading to miss a dose of Apixaban - just a personal observation

[Gertsen]

I had a tooth extracted without stopping Apixoban not problems.

[EricW]

I think Dabigatran is similar to Apixiban being one of the new anticoagulants. My consultant suggested I stop taking it 48 hours before the procedure and sent me a note to this effect to give to the dentist. I resumed taking it again the following day. I had bleeding for about eight hours although not heavy. It seems there are varying opinions on the best way to deal with this issue.

[Hidden]

Yes, stayed on the NOAC (Adoxaban)

I don't think I bled any more than before i was on A/C

Just remember to ask for a non steroid anesthetic

[terryw]

Hi Caradomben. I had an extraction last year, but despite suggesting to the Dentist that I stopped Apixaban 24 hours before it he did said that it was not necessary. Afterwards I had to return to the Surgery twice with bleeding. The first time he stopped it for a while, and the second time for stitches. Over the next couple of days I had two trips to A. & E. By the time I saw the Doctor on the first visit my bleeding had stopped (I had missed one day's dose of Apixaban ). Unfortunately my bleeding started again when I went back on Apixaban. At my next visit I was given for a week a reduced daily tablet of Tranexamic which 'did the trick'. I lost some time and sleep during this event, but that was all! As you can see from the other replies just like everything else individual bodies react differently. Good luck. TerryW.

[Dodie117]

I had extraction and did not stop apixaban. On my own initiative I adjusted time of dose over a week so I was at the lowest point at time of extraction.

No bleeding.

[Caradomben]

Thanks everyone for your replies . Unfortunately I have to wait because at present I am on prednisolone for gout and this is contra indicated too for tooth extraction . The tooth is packed just now so hopefully it holds out for a few weeks .

[Tapanac in reply to Caradomben]

My husband is on prednisolone and has been for years. He has had two or three teeth extracted and no problems and no stopping the tablets. I don’t know who told you not to have teeth taken out whilst on it as GP and dentist had no problem with regard to it. Good luck

[Sebhel]

I only had issues with the pain killer medications, which you have to check with your dentist and your pharmacist! (Only some pain killers can be used with Apixaban) In my case the tooth involved was the closest to a sinus, which it had pierced? This added to somewhat to the pain over and above the effectiveness of the pills.

[Bettiehough]

I had a front tooth extracted and a Maryland bridge placed on the day. I did not go off apixaban I was fine with bleeding when it was extracted but I wore a dental appliance for sleep apnoea which seemed to irritate the wound and I. woke up one morning with a mouth full of blood. Luckily i sleep with my retired dentist who still owns half of the practice so I was rushed in and bleeding was stopped. I had a few bleeding episodes afterwards until we realised it was the dental appliance causing it but hubby dentist just brought the stuff home and stopped the bleeding at home