I am on Apixaban and I have to have a wisdom tooth removed. My Dentist is reluctant to do it without consulting with my GP. He has no experience with Apixaban. And is in need of advice with regards the stopping of Apixaban prior to the tooth removal. I cannot get in touch with my GP due to surgery restrictions due to COVID 19. I can only make online appointments, and there are none available before he middle of August. My Arrythmia nurse cannot help me as there are no consultants available at present that she can ask.
Has anyone advice on stopping or reducing the Apixaban in this situation?
Written by
Capri62
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General rule should be don't take the pill on the day before and re-start straight after. Your dentist should be able to get this advice from his professional body for goodness sake!
I take Apixaban and have had two big, nasty extractions - one being a wisdom tooth which was shattered.
For the first planned extraction, I was seen at 8 am which was standard protocol at the practice for anticoagulated patients. I delayed taking my tablet for an hour and had no problems. The second was the wisdom and was an emergency extraction without worrying about Apixaban!!
Your dentist should have a protocol in place for anticoagulated patients - there are a lot of us about. In these bad times it might be difficult, but I would try to find another dentist up to the job. Best wishes.
Well I'm absolutely flabbergasted. Where on earth do you live that you get such poor medical care?
My dentist took out a wisdom tooth for me and he knew exactly what I should do re anticoagulants. I know my lovely AF nurse Shelley would also be able to tell me anything more I needed to know.
If I rang my doctor's surgery (NHS), a doctor would call me back that day at some stage depending on the question I was asking. If they thought my complaint needed it they would call back almost immediately and if they thought I needed to be seen I'd be down in the surgery for a face to face consultation within hours.
I'm not saying this to brag, just can't understand why if my surgery can do this others in this country can't do the same. I feel so sorry for you.
I hope a forum member on here will be able to advise you, but I'd ring your surgery and ask that question about your Apixaban to a receptionist and ask her to get back to you with the answer.
I don't understand her surgery either Jean, that is disgraceful care. I called my GP last week because I had a bleed in the eye, she didn't hesitate to see me within a couple of hours to check it out. I also went back the following day for blood tests.
Surely someone should be available to answer Capri62's question.
I would consider changing your dentist. As Bob says that information should be easily available from their professional body who are the right people to advise them on best practice.
I had major work done at NHS hospital and none of the consultants new about Apixaban, I was amazed. Anyhow, they eventually got some info and I was told to stop taking them about 24 hours (something like that) before the op, and to restart immediately afterwards.
I did just that and had no problems. I was told at the time, that if the work was equivalent to 3 "normal" extractions or more, then stop Apixaban, but if less then don't stop. My work was well over that boundary. As I say that was 2 years ago and advise may well have changed.
I had 2 teeth extracted in January and was told by my dentist not to take Apixaban on the morning of the extraction. Most dentists should be geared up on most anti-coagulants, as there is so many of us that take them.
I've had two back molars removed in the last month on separate occasions. Both times I was asked not to take my Apixaban on the day. Both appointments were first thing in the morning. Dentist stitched both sockets to help close up and gave me extra wadding to use over the next few hours. My dentist was fully aware of the procedure and everything has progressed as normal. HTH
I have had an apiectomy ( rework on root canal) and wisdom tooth removal at our local dental hospital.
Both times I had an early morning appointment,was told not to take night dose of apixaban then after the work had been done take morning dose. This was in the last 7 months and I had no problems at all.
Also check that you are given non adrenaline anaesthetic !
I had a tooth extracted whilst on Apixaban my private dentist was unwilling to do it without a letter from my GP. There are NICE guidelines on line for dentists to adhere to so there shouldn’t be any problems really. I didn’t take my morning dose until a couple of hours after the procedure. I had no problems,
My dentist refused point blank to do a wisdom extraction while I was anticoagulated. I had to make an appointment with the Maxilofacial department of the local hospital. The Head of Department there was scathing about the competence of typical "cosmetic dentists". On the plus side, he was good at his job and it was free.
I mentioned to him the issue with adrenalin injections and he explained that the adrenaline "holds the anaesthetic to the tooth". For AF and other heart patients, he uses less adrenaline, but not adrenaline-free, which he said would be counter-productive.
I had a LARGE tooth removed and had to stop the apixaban the night before and the morning of the extraction. Then re-commenced that evening. All was absolutely fine. No worries. Good luck with the removal.
PS....my husband just reminded me, he said he was sure I just had to stop the apixaban the morning of the extraction and started again that evening (I take them at 8.30am and 8.30pm) I probably am confused with the amount of procedures I have had lately. I felt that I needn't have stopped at all as there was very little blood and no problems. Again good luck
Thank you to everyone for there advice and relaying their experiences. I have finally managed to get hold of a of a Doctor from my surgery . But she would not advise me as to to the best course of action. She stated it was up to the Surgeon performing the procedure. She did however call me back ten minutes later
to tell me she had looked up some information on the Oxford Uni site, this advised to miss one dose of Apixaban for a low risk procedure. and two dose's for a high risk procedure. I relayed this to my Dentist. He will make enquiries prior to carrying out the extraction (which is next Wednesday).
I believe their reluctance to advise probably due to the fact that i have a history of Stroke and brain bleeds.
This forum has been of more help than the professionals so far.
Sounds like you need a new dentist. They should know what to do as millions on people take these medications. There is plenty of professional advice available to him/her.
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