My question is regarding dental extraction. At the end of this month, I am due to have four dental extractions: Two stumps (it’s a long story); the root of a crown which came off recently and where there is insufficient root left to re-join the crown; and a leaking abscess which appeared the day before Christmas, in a front tooth. These are all upper teeth.
Bearing in mind that I have afib and am on apixaban 2.5mg morning and same again in evening, I am somewhat concerned regarding the bleeding aspect. I shall be having a cosmetic denture fitted at same time, so this will act, to some extent, as a plug!
To be honest, I’m a very nervous dental patient and the thought of coping with one extraction is bad enough, but four and possible bleeding problems. I had a large lower back moler removed, about four years ago, without stopping the apixaban. This went well and settled by the evening. It was a Wednesday, but the following Saturday mid morning, it started to bleed again. Good telephone advice from dentist all day, but eventually she said to go to A and E, where I was given, just after midnight, a gauze soaked in some special acid, to press over the wound. I sat like this until 4.00am when situation resolved and the nurse saw me off the premises with a caution, ‘ don’t go to bed for another hour’. 🤣
This time, I have been told to stop the morning dose of apixaban and re-commence as normal, later in the day. Your kind thoughts would be most welcome. Rosa.
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Four teeth extracted sounds a lot to have removed in one go. I had a back tooth removed a few years ago and that was enough! Had it removed in the morning and was still bleeding slightly in the afternoon, so went back to the dentist He gave me some gauze swabs and told me to keep pressing on the gum with that and it worked.
Sounds exactly the same as myself when I sat up all night in the hospital for four hours pressing the gauze to my gum. And that was only one tooth, albeit a big one like yourself. I do agree with you Jean, four extractions sounds a bit OTT. Perhaps I should have the abcessed tooth removed - and then escape! Why can’t we have teeth replacement like sharks, where the next layer moves forward.
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I was having an extraction while on apixaban 5mg twice daily and I was advised by my dentist and GP to stop the anticoagulant the day before to avoid complications with bleeding and to re-start taking it directly after the procedure. Apparently it leaves the system quite quickly hence only stopping it for 24 hours. I had no problems and was in sinus throughout. Good luck - sounds like quite an endeavour.
My dentist advised no apixaban morning dose, prior to extraction and to restart evening dose. I shall quiz him again today, as going for the dental impressions at lunchtime! Thanks for your advice. Rosa.
I had to have an extraction 3 weeks ago following an abcess and gum infection. The infection as well as the pain made me feel very unwell. Had a weeks supply of anti bio tics before extraction. Take apixaban 5mg twice daily.
I stopped for 24 hours before treatment and left it for a further 12 hours post extraction.
My gum weaped for for 1w hours. Advised by dentist to form a lint plug and keep it gently pressed against gum.
I’m sorry you’ve experienced an abscess with horrible side effects. I think it was the Scottish Poet Robert Burns who said that toothache was the hell o’ all diseases. How right he was! I’m glad you’re healing well now. You’ll have a smile on your face now that the abscess and allied work is all in the past.
I’m at the jumpy stage, but you’ve no idea what a measure of support it is that so many genuine members, who’ve had problems of their own with dental work, are interested to write with their own experiences. I shall make sure I have a good supply of appropriate gauze beforehand.
Ah yes! The Tooth Fairy. Haven’t made contact with same for a long time. But do you know Tryfan, there are times when I still believe in magic and since you kindly gave me the idea, I think I may just buy a lottery ticket and pop it under my pillow! Wouldn’t that be something! ☺️ Rosa.
I stopped taking apixaban 24 hours before my marathon dental work last year (waiting for a post to be put in for new tooth at the moment) and started taking 12 hours afterwards. ~For one tooth the dentist did say there was no need to stop but I feel its best myself. My consultant asked me to stop 3 days before cataract operation and got to say more bleeding occurred after the dental work I had last year than from the cataract op - though I do understand any bleeding from the cataract op would probably be more of a concern .
I understand you should also ask for your dental anaesthetic to be a different kind ie without adrenaline if worried about the effect on AF.
on reading the variety of helpful comments from all you lovely people, it’s amazing the actual spread of individual advice from the doctor or dental practitioner to the patients concerned. When I went for the denture impressions yesterday, the dentist (new to me - and he is very professional and very understanding - since my old one left!!!! Enough said) he said that he would do the extractions and then fit the denture straight away. I understand this is standard practice. I hope it will reduce the probability of bleeding. I think what is at the back of my mind is the experience I had, as I outlined in my original question, about having to sit up all night pressing gauze, impregnated with a special acid, over the extraction site.
Thanks for mentioning the adrenaline free jab. That’s what’s on my dental notes. And thank you for your advice all round. Rosa.
Hi, agree with others that 4 seems over the top. I had to have 2 extracted before I could have mitral valve repair, apparently cos bad tooth bacteria worse thing for heart. Had extractions in separate weeks, first ok, second took 2 hrs and needed stitches after so heart op had to be delayed. Dentists don't know how long it will take before they start so 4 seems absurd. Also you may need antibiotics before the extractions and perhaps adrenalin free anesthetic, need to checkout with dentist and heart medics
that’s awful! Two hours for one extraction. And stitches! Must have had extra roots to remove. I think I’d be in orbit! I understand that bad tooth bugs are not good for heart health. I understand also about antibiotics before and after, but unfortunately I have a bad reaction to certain of these drugs. I’m plugging away twice a day with salt water rinse. Fortunately I already have adrenaline free jabs. My list of questions for my dentist is growing. Will keep you all informed as the saga progresses. Thank you for writing and for pointing out all these important issues. Rosa.
I've had a few dental extractions before dental implants, and was advised by the dental surgeon to stop my Xarelto two days before the procedure, day of the procedure, and resume the day after. My EP okay'd this, and all went well.
this is such an excellent site where honest opinions can be put forward. I’m collecting the information together and when I go for a second fitting, I shall present the advice in a one-er and will be interested to see his response. Thank you Snowgirl65. Much appreciate your writing. Rosa.
I take Eliquis and had 3 teeth removed and had no problems with bleeding. Most of the problems I've read about online were from people on Warfarin. I really can't understand why any Doctor would still prescribe that mess. Anyway, good luck with your procedure.
Apologies for delay in replying as I was away yesterday having the fittings for the denture done. Information such as you have given me helps such a lot. Thank you. Rosa.
Hi RosaSurely you can stop the blood thinner the day before and restart the day after. Of course I'm no expert but you should be ok i would have thought
There seem to be varying degrees of advice. My dentist cheerfully advised to stop the early morning 2.5 dose of apixaban on day of procedure and restart next dose of 2.5mg that same evening.
I had a large lower back tooth removed some time back. It was removed without stopping the apixaban. Day of procedure was all right, but three full days later the socket started bleeding again and went on all day and throughout night until about 4.00am.
I didn’t honestly mind that. After all it was one very large tooth, but I must admit to being nervous of having four extractions in a one-er! 😳I’m to have a cosmetic plate inserted immediately!
I just had the thought that, man has walked on the moon and lo and behold, we are still pulling teeth as in days of yore, albeit in a slightly more sophisticated manner.
Thank you for your kind thoughts and for writing. Rosa.
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