Stopping or not stopping Apixaban for denta... - AF Association

AF Association

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Stopping or not stopping Apixaban for dental treatment

SuziElley profile image

I asked my GP surgery about Apixaban and dental work but they said ask the dentist. The dentist says ask then GP. Anyone else had this runaround and if so, what was the outcome?

39 Replies

What are you having done at the Dentist's? Not long after going on apixaban I had some major work done and the Dentist said I needn't come off and the Doc agreed but I was worried as had been told in the hospital to come off for other minor procedures done in hospital. So I decided not to take my tablet that morning - had the work done around mid day and took my tablet at 8pm. I have no idea if I was right or not to do this but I figured it was just as if I had missed a tablet. Having said that now I think I would do as advised. Have you asked your cardiologist or cardiac nurse?

SuziElley profile image
SuziElley in reply to Desanthony

I had half a tooth break off……. Not sure what he intends to do with it.

I spoke to my dentist as on apixaban too ,getting one molar out ,,, asked not to take it night before dentist ,, but take it that night as normal after app , consultant agreed ,,, like Bob said time to change dentist ,

Only problem there is, no dentists in our area are taking on new patients :(

If you’ve any other issues your not sure about ,this is a great site for help and good info ,,, but if in any doubt contact your consultants secretary, I find any issues I’ve git they are very helpful,

Thank you. I’ve just decided to do just that

Bob is wrong.

In what way

Desanthony profile image
Desanthony in reply to SuziElley

If he is going to cap your tooth then I would imagine there is no problem with taking apixaban as he is not going to be going into your gum. If he is taking the whole tooth out and doing other work then I would be wary. Verify exactly what the dentist is going to do and if you are still concerned call and speak to your consultant's secretary.

SuziElley profile image
SuziElley in reply to Desanthony

Will do. Many thanks

BobD profile image
BobDVolunteer

I would change my dentist. If they are not up to speed on this simple problem just how good are they? The professional body issue guidelines after all. I take warfarin and have never needed to stop for any dental work.

By the way don't forget to ask for non adrenaline local as many with AF find the adrenaline sets them off.

SuziElley profile image
SuziElley in reply to BobD

Thank you Bob. I hadn’t thought about the adrenaline.

reinaway profile image
reinaway in reply to BobD

I asked ,my dentist for non adrenaline local and he said he had to include it to counter any bleeding. My AF was okay but I was apprehensive about it.

BobD profile image
BobDVolunteer in reply to reinaway

Again change your dentist. The ony reason not to use it is that they will need twice as much in some cases as it doesn't last so long.

SuziElley profile image
SuziElley in reply to BobD

Impossible to find a dentist in our area taking on any new patients :(

SuziElley. I had a tooth removed 2 weeks ago , my appointment was at 11am , Dentist said to miss the morning dose of Apixaban which I did. After extraction he packed my gum and put a stitch in. No bleeding at all. My stitch came out itself yesterday so all good and a very smooth procedure so don't worry.

SuziElley profile image
SuziElley in reply to Nerja2012

Thank you for replying

Dodie117 profile image
Dodie117 in reply to SuziElley

I had a wisdom tooth removed but took my Apixaban as normal. No bleeding.

I feel that it is the dentist's ultimate responsibility for the procedure and he/she shouldn't pass the buck like this.

I take Apixaban and have had 2 extractions (big ones) and several fillings - none of the dentists involved asked me to stop Apixaban. For the upper extraction I decided to delay my dose for 90 minutes but I had no problems even when the second (lower) extraction had to be done urgently a few hours after I had taken the tablet.

If you are concerned, ask to have an early appointment and take your tablet afterwards. Best wishes.

SuziElley profile image
SuziElley in reply to Finvola

Thank you so much

Scroll down today’s posts and see one from Ayenwaters about Apixaban. I put a link there regarding NICE guidelines and if you scroll down it will tell you all you need to know about managing dental work.

SuziElley profile image
SuziElley in reply to FlapJack

Thank you so much!

I had major work done a couple of years ago and had this problem. Eventually the dental surgeon at the hospital said that I should only stop Apixaban if the work was equivalent to having three or more teeth removed. My work was indeed greater than that (even though it did not include extractions), so I had to stop Apixaban shortly before the op, then started again straight afterwards.

My dentist has also conformed that the three-tooth rule is what he goes by.

As I say, this was a couple of years ago.

SuziElley profile image
SuziElley in reply to Cyrtis

Thank you for your reply. If I don’t get anywhere with any of them I’ll carry on taking it. If it’s wrong they’ll just have to make another appointment for me…..

I had two back molar extractions a few weeks apart earlier this year. My dentist just asked me to stop my Edoxaban on the day. She packed the cavity and I had no problem with either. Hope it goes well for you, I hate having dental work done!

I had dental work on apixaban and didn’t have to stop.....but I did have to take antibiotic the morning of the dentist, it’s a precaution with infection and heart.....I have seen in here some folk get told to do this some don’t.....wish all dentists were up to speed, it’s not complicated is it.Sue

SuziElley profile image
SuziElley in reply to Morzine

Thank you

Dentist told me I didn't need to stop (low dose) Apixaban for a wisdom tooth extraction due to abscess / filling a cracked tooth. I then had non-stop bleeding, was awake all night spitting out blood, had to go back several more times for packing, stitches etc.

GP then said it should have been stopped.

The problem is no interface between medical and dental services. Another GP told me they're are not allowed to advise or prescribe if you have a dental issue / issue possibly related to dental problem, even if it's affecting you medically/systemically as the dentists "get very angry". (I urgently needed more antibiotics and couldn't see or speak to the dentist or get emergency care).

SuziElley profile image
SuziElley in reply to Frodo

Hmm, thank you Frodo. I think I might ring EP and ask

Sparky143 profile image
Sparky143 in reply to Frodo

Frodo, you are right. The Cardio docs and dentists need to get on the same page. Trouble is, dentists don't know about cardiology and cardiology doesn't know about dentists! My dentist prior to a recent extraction which involved a complicated oral surgery and stitches because the tooth is broken off to the gumline as well as a bone graft, needed a clearance from my cardiologist before he would work on me. The cardiologists are quite used to this and have a form letter that they fax in giving permission. Nothing was mentioned about the blood thinner. I am on Eliquis. But I went by what my two former cardiologists had told me which was to stop for two days. Many people under the age of 60 are on blood thinners unecessarily according to Dr. Sanjay Gupta of York Cardiology and I believe him. Dr Gupta tells you the truth. He is not a slave to the system. America is way way way over medicating people! Even though the cardiologists have NO CLUE what is causing a fib and there's an epidemic of a fib in America and the doctors have NO IDEA(!) what is causing it!!! Something not right there. Good Health to Everyone! Sparky💖

I was told by my EP to go off it for a day for my oral surgery.

Hi SuziElley. I have had two extractions this year (each at a different time as the dental practice I was sent to only take one tooth out at a time). My own dentist does not do extractions so I was sent to a special practice with a dental surgeon performing the extractions (which due to Covid I had to wait a year for!!). They were excellent in informing me beforehand that as I was on Apixaban, just to stop taking it for 24 hours before the procedure and then I could start it up again 6 hours after having the tooth out. I hope this helps

SuziElley profile image
SuziElley in reply to betsgirl

Thank you 😊

My dentist (not NHS) asked me to carry on with Apixaban as normal prior to the extraction of one tooth. No stitches were inserted. I was given advice about what to do afterwards. There was some bleeding, but there was no problem. I am firmly of the view that the responsibility for dealing with this situation lies wholly with the person carrying out the dental treatment.

I had an cyst removed from gum with tooth, but I take Rivaroxaban. My dentist said it was not necessary to stop my meds as that would be more dangerous. He carried out the work, took and hour, had 4 x stitches and all was fine. No probs, but I did go Private.

A week ago I had a major extraction of 2/3 of a molar that my dentist had been unable to take out. This was a surgical extraction, at my area general hospital, normally carried out under heavy anaesthetic. It bled quite a lot, and this was expected, as there was some cutting of the gum and slight drilling of part of the jawbone. In my case, the consultant surgeon was entirely clear. I was told to stop my normal twice-daily apixaban, but only for the night before and the morning of the operation. I was advised to resume apixaban the evening after the op even if still bleeding, unless I felt it was excessive. It took about a day for the bleeding to almost totally subside, but otherwise it was fine and I never felt there was an unusual problem. Hope this experience helps.

SuziElley profile image
SuziElley in reply to BillCook

Hope you’re all healed now

Sparky143 profile image
Sparky143 in reply to BillCook

Sensible and same as me pretty much.

Hi I had a tooth extracted some weeks ago.Had no problems at all,did not need to stop apixaban, the dentist inserted immediately some clotting pack and it healed very quickly.My dentist clearly was au fait with the issues and implied most dentists would/should be.

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