Advice, please, on stopping apixaban for dental work

[jusjay9]

About three years ago I had to have dental treatment (scaling and root planing) that can involve some bleeding. I tried to get advice on whether or not to discontinue my warfarin (and if so, when, and when to resume) and found myself in the middle of a sort of three person pass-the-parcel game. GP said ask the dentist, dentist said ask the GP and when I said GP told me to ask the dentist, dentist suggested I try the warfarin clinic, warfarin clinic said.... Well, you get the point. Now I have to have the same treatment again, and thought I'd get better informed advice here. I'm now on apixaban not warfarin and thought that since apixaban is short-acting I could stop the night before the dental appointment and start again the next night if there wasn't much bleeding or the morning following treatment if there was. OK? (And how long does it take for a blood clot to develop anyway???)

[KipperJohn]

I believe this is quite a common issue where invasive procedures are concerned. I’ve been on Apixaban for about 5 years and had 2 ablations, a hernia operation, tooth extraction with stitches, prostate biopsy, endoscopy and so on. Each time the professional performing the procedure has advised on how long to stop taking Apixaban. If they don’t know they should consult either your cardiologist or EP if you have one. Whoever prescribed you Apixaban really ought to know!

All the best.

[jusjay9 in reply to KipperJohn]

Thanks much. Impressive qualifications -- I think you've had even more nasty things happen to you than I have in the last five years; hope it's smoother sailing for both of us in the next five. "My" cardiologist is whichever registrar's on duty when I have an appointment and tracking down the one who prescribed apixaban .... Even getting anyone at all to answer a question without having an appointment is close to impossible.

[Paulbounce]

I also had a similar problem JJ. I only wanted a scale and polish. The dentist said not without a doctors note, and the doctor said it was up to the dentist.

Rock and a hard place !

I found another dentist who checked it and said it was fine. Note it was just for a clean though. I made an early morning appointment and took my med`s after - there was little bleeding so it worked out that way.

A clot from afib can form in as little as two hours. It`s unlikely but it can happen.

Is it worth you checking with another dentist ?

Best,

Paul

[jusjay9 in reply to Paulbounce]

Thanks. Nice to know I'm not alone! And I am checking on changing dentists.

[Paulbounce in reply to jusjay9]

No worries Call a few - tell them about your situation and see what they say. Some seem more on the ball than others regarding this.

You are not alone - the joys of afib heheh.

Best,

Paul

[dedeottie]

I usually look up and take with me the NICE guidelines. If you do a web search just put in NICE guidelines for apixaban and minor operations. So far I have never had to stop apixaban fo any more than 12 hours. Good luck x

[Finvola]

I’ve been taking Apixaban for 5 years and in that time I’ve had 2 large extractions - one was a split wisdom tooth and was horrendous -descaling every six months and several fillings. I’ve not had to stop Apixaban and have had normal seepage after extractions and no other problems.

In my opinion, a dentist should be prepared to treat anticoagulated patients and should have a protocol in place. I would be quite nervous of one who passed the buck like yours did and I would certainly ask ‘what is your protocol for Apixaban patients?’. I’m not familiar with root planing but would try to find a dentist who will give a sensible answer - if in doubt I would also run it past my cardiologist.

[Lizty]

I have had some complex dental work done over the last year. My dentist said I did not need to stop apixoban. He's a very good dentist, so I trust him. However, I am surprised that your own dentist cannot advise you. He must treat many patients who are on different drugs. Check with him again and if he doesn't know, tell him to find out!!

[pusillanimous in reply to Lizty]

Yes before my dentist started any treatment I had to supply him with a list of all drugs and supplements I was taking,

[Hidden]

Having an extraction and implant in August and my dentist is aware I am on apixaban and has not told me to come off it ! For what your having no need to stop it !

[jusjay9]

Please forgive this general thank you to all who have responded to my request for info. I am so grateful to you all for your help, but another of my ailments makes typing difficult and slow (and yes, in advance of getting A-Fibbers' suggestions, I am experimenting with voice to text options :-)). I have "liked" you all as a way of making my thanks a little less impersonal, but please let me repeat my heartfelt thanks for all the good info, suggestions, and support I have had. Best wishes to all.

[Dodie117]

I had wisdom tooth removed and did not have to stop apixaban. On my own initiative I tweaked the time I take apixaban for a week so I was at the lowest point in the cycle when I had the tooth removed.

All fine.

[Nugger]

What is it with them dentists, had the same happen to me, say blood thinner & they go weak at the knees!

Doctor that put me on Apixaban cut out a skin cancer on my forehead,3 stitches & it was me that said to him, you do know I’m on Apixaban ?

He says, you’ll be fine & I was lol

[Xerxes8840]

The accepted standard seems to be to stop the drug 24 to 48 hours prior to dental procedure, depending on the risk of bleeding during procedure and your general health. Discuss with your cardiologist or whoever prescribed the drug, as most dentists will defer to prescriber.

[jusjay9 in reply to Xerxes8840]

Please forgive this general thank you to all who have responded to my request for info. I am so grateful to you all for your help, but another of my ailments makes typing difficult and slow (and yes, in advance of getting A-Fibbers' suggestions, I am experimenting with voice to text options :-)). I have "liked" you all as a way of making my thanks a little less impersonal, but please let me repeat my heartfelt thanks for all the good info, suggestions, and support I have had. Best wishes to all.

[Gowers]

I am in the middle if dental treatment - extraction, bone graft, plate and implant. The 1st appointment was 7hours long! (had to wait for impressions & plate to be done) i came off the rivaroxaban blood thinner 2days before on advice from cardiologist after i phoned his secretary and she asked for his advice.

I have had 2nd part of treatment which involved 2 incisions & 4 stitches and each time i have bled on & off for a day but no blood pouring out which I dreaded.

My dentist advised i check with the cardiologist. So I think perhaps it would be best if you can do similar.

There seems to be varying advice with these newish blood thinners & as we all react differently I wanted to be sure I was doing the right thing before having any of the treatment/s

[foxglove1]

I have been on Apixoban for over 3 years and have had no problems at all with dental visits. Like nugget I also had a skin cancer removed a year ago which involved 8 sutures. The Apixoban was not stopped and the surgeon told me I hardly bled at all.