Stopping Apixaban before tooth extraction.

I have a tooth extraction impending and am not sure whether I need to stop taking Apixaban. The dentist said that I should ask the GP. A cardiac nurse (who I was talking to about something else) said the same thing. I rang the GP surgery and they told me a GP will call me (which I didn't think was really necessary). In the meanwhile I wondered if anyone knew the answer. From googling I have found different answers: mostly the unhelpful (in my case) "your dentist will know whether you need to stop taking Apixaban". Also, if anyone can recommend a clinic in or around London where they do good quality but low-priced implants, please let me know.

[BobD Volunteer]

Perhaps that should fread "your dentist SHOULD know!" My own has never worried about me being on Warfarin provided my INR is under three. It seems many just won't accept responsibility which is sad since they have adequate guidelines from their professional body. Regarding implants I can't offer advice other than cheap and good quality seldom mix.

[Hidden in reply to BobD]

I think you are right about dentists being unwilling to take responsibility-I cannot believe they don't know the answer, as I am sure I am not the only patient they have treated who takes an anticoagulant. On the implants, I haven't had one before and the prices seem to vary widely from about £2000-£3500. I regard dentistry as something of a scam and don't want to pay them a penny more than is necessary.

[jeanjeannie50 in reply to Hidden]

I agree with Bob your dentist should know. Mine told me I didn't need to stop Warfarin when I had a back tooth removed.

[mrgwair567]

Hi Samazeuilh, When I see the dentist, I don’t take my morning dose of Apixaban.

I’ve never had any problems with any extractions. Very little bleeding.

Hope this helps.

[4chickens]

I recently had a wisdom tooth out without stopping apixaban but the dentist did put a couple of stitches in as a precaution afterwards

[CDreamer]

Agree - dentist should know. I’ve never stopped Apixaban for dental work but if it’s a big extraction then I would imagine just miss your morning dose?

[Desanthony]

My Dentist, GP and cardio said not to stop it for an extraction I had early on when taking apixaban but I did stop as worried about bleeding. To be honest if they all said that again I wouldn’t stop it I was just not used to apixaban as had only been on it for about 3 months maybe not even that and I was so worried about bleeding out. However, you should check with your cardio and dentist.

[CDreamer]

PS my dentists have always been absolutely on the ball about taking responsibility & go through my meds at every visit to ensure nothing has changed or note what has.

[Hidden]

Link to NICE guidance below. Just scroll down and you will find the section relating to dentistry and surgery. I had a wisdom tooth removed some years ago and found it impossible to get advice from anyone. In the end, I decided to miss the dose before the extraction and there was no excessive bleeding. I’m not medically trained but many medics have said that missing a dose of Apixaban is not particularly risky. Most of us have accidentally missed doses and have not had problems.

I’m no expert on implants but agree that cheap and good quality rarely exists.

Oops, forgot the link!

cks.nice.org.uk/topics/anti...

[Hidden]

Thanks to everyone who has replied to this.

[Bagrat]

I was told not to stop apixaban but like Desanthony I decided to omit the morning dose. Told dentist who said it was good I did as had a bit of bleeding ( I was totally unaware) All good once home and did the same with next extraction too.Apart from fact I was reluctant to part with tooth the second time so needed a top up of local as I ask for non adrenaline (epinephrine) containing injection and it disperses more quickly.

[Buffafly]

Changing my name to Buffy the Vampire Slayer after my recent experience. Yesterday I had long awaited dental surgery to remove roots from a large back tooth which was too near my sinus. In the first place my own dentist said she was not allowed by the surgery to extract the tooth because they had had a bad experience with a patient on Rivaroxaban who had ended up in A&E. The hospital consultant said the real problem was possible damage to the sinus and wrote a rather snippy letter to the surgery about the mistake and how to prevent excessive bleeding. When I finally got my appointment I asked about missing my morning Apixaban because I had had a bad experience with bleeding before but he told me firmly that their ‘magic sponges’ and a stitch would take care of bleeding. Thus reassured I took my morning dose and fortunately the surgery was not as bad as it might have been. I was sent home with one small piece of gauze and instructions not to worry about blood in saliva unless ‘like a nosebleed’. I hadn’t even got home before the hole started bleeding gently, which it continued to do all afternoon in spite of several attempts to stop it by compression - not firm enough because of the pain. Then I absentmindedly took my evening Apixaban which was a mistake because I woke during the night with the full Vampire effect - blood soaked pillow etc. I toyed with the idea of 111 but knowing their fondness for sending you to A&E I decided I’d make proper job of the compression first so I found some smooth makeup remover pads, rolled one up, bit down hard and never mind the pain and read a book for a long time. Bingo! And back to sleep eventually. So my advice is never mind what anyone says, miss at least one Apixaban. End of horror story 🫣

[Dodie117]

My dentist in uk said no need to stop. Now in Ireland and dentist here also said no need. Both extractions with no problems and no bleeding.

[Hidden in reply to Dodie117]

Thanks to you and the others for the replies.

[Ducky2003]

I just chose myself to miss my morning dose when I had a tooth out. Just as well as it continued to bleed until the following morning. Needless to say, I didn't take the evening dose either.

I have to have valve repair surgery and I asked the surgeon about stopping the Apixaban the night before. He said absolutely not, I must stop it 5 days before as it stays in your system longer than people think 🤷‍♀️.

[Hidden in reply to Ducky2003]

Thanks for the reply.