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dentist and anticoagulants

ILF1 profile image
ILF1
11 Replies

On Thursday I am having two broken teeth removed - both are broken right by the gum so my dentist referred me to an oral surgeon as they were worried about tooth cracking etc. I believe on at least one they may need to cut the gum a little as the tooth isn’t showing but am no dental expert!

I take 1 x Edoxaban at 5pm each day. My dental treatment is at 11am. I have been told to stop Edoxaban the day before. Am extremely nervous about doing that and called my AF nurse today. She wasn’t clear - sent me the NICE guidelines but didn’t say definitely to stop or to carry on taking the medication. The guidelines say not medication to stop for low risk bleeding treatment (up to three teeth) but to stop for higher risk - my problem is I don’t k or what risk I am.

Has anyone had similar dental work and did you stop your anticoagulant?

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ILF1
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11 Replies
swansong75 profile image
swansong75

Hi, I’m on rivaroxaban and had a wisdom tooth removed. I didn’t stop my medication and it was ok. It bled slightly for around 12 hours but not much. Kept pressure on the wound with the padding the dentist provided. Hope this eases your fears

Mrsvemb profile image
Mrsvemb

I had two surgical extractions done on the same day. Both were like yours broken off at gum level. Unfortunately this is the price I pay for having root canal treatment years ago with the nerve removed.

I take Dabigatran and my dentist told me to stop them 48 hours before. I actually stopped 36 hours before. He did the first one and stopped the bleeding before injecting the other side and proceeding with that one. Again it was fine. I left there with no bleeding.

One thing I did say to my dentist was that if during the time that I had stopped the Dabigatran I got AF, then I would restart the Dabigatran immediately and reschedule the appointment. He was ok with that, but I didn’t need to.

ILF1 profile image
ILF1 in reply to Mrsvemb

Thank you - your extractions sound exactly like mine, one either side and broken at him level and both have had root canal treatment previously.

Glad it went ok for you - I am nervous but hope it will go well. I am thinking of taking half dose of anticoagulant the afternoon before - somehow I don’t feel happy stopping it all together. Just hope my dentist is as good as yours was. Thanks again

Mrsvemb profile image
Mrsvemb

I am sure you will be fine. My dentist is an oral surgeon too, which helps.

No more root canal treatment for me. This has happened to me before as well. In fact, I have another tooth that has broken off at gum level to come out.

Don’t forget to ask for the injection without adrenaline, as that can trigger AF. My dentist tried to persuade me to have the adrenaline one but I refused. The injection works fine, but doesn’t last as long. That is why he didn’t inject the second one until the first one stopped bleeding.

Good luck with it. Let us know how you get on.

Desanthony profile image
Desanthony

My mouth is a mess thanks to Military dentists - I spent 37 years in the Military. So I have had quite a few teeth taken out while on apixaban. The first was just after I started apixaban and although the dentist said there was no need to stop apixaban that day - my appointment was at 2pm I decided to not take the morning apixaban. I have no idea if it made a difference but since then I have had teeth out and lots of cosmetic work putting new teeth in and sometimes I have taken the apixaban - purely because I have forgotten and for me it has made no difference at all. Have you spoken to your dental surgeon about this?

terryw profile image
terryw

Hi ILF1. I have had three extractions . The first was a disaster resulting in two return trips to the Dentist, followed by two to A. & E. to stop the bleeding. I had stopped one dose of Apixaban before the tooth was removed. Afterwards neither Dentist, or G.P. wanted to propose when, in my case, I should stop the drug. Luckily I have a good Cardiologist and after I contacted him he told me to stop three doses of Apixaban before the extraction, and one after. After the extraction I still bled and decided to stop a second tablet. The Cardiologist contacted me agreed with stopping the second dose, and advised me to stop a third. Since then I have had another extraction and followed the same procedure stopping three before , and three after. I still bleed, but it stops sooner! I found the NICE Guideline vague. Remember we all react differently to the same circumstances. The best advice will come from a Cardiologist. You may not be a 'bleeder' like me!

My Cardiologist was not too happy with the drug given to me by A. & E. to thicken my blood! Good luck! TerryW.

Buffafly profile image
Buffafly

I had dental surgery for a broken tooth too near my sinus. I was assured I didn’t need to stop, methods used would stop excessive bleeding. Despite all precautions I nearly had to attend A&E in the middle of the night because of heavy bleeding. When I told my GP she was very cross, said the advice was wrong! Btw, I take Apixaban.

Auriculaire profile image
Auriculaire

You are not stopping for very long. I stopped Apixaban for 3 days before hip surgery. This is normal. After 36 hours there will still be some left in the body and according to the manufacturer's info it only takes 2 hours after taking it to reach max levels and you should be able to do this soon after your procedure.

Davekh profile image
Davekh

I was referred to an oral surgeon about 3 years ago for a difficult extraction. My dentist was a bit concerned about blood thinners but the oral surgeon didn't seem too bothered. I didn't stop my medication as I felt it was doing a far more important job in staving off the possibility of a heart attack. I didn't experience anything any worse than other extractions pre medication. I am sure you will be OK,

Bagrat profile image
Bagrat

My first extraction on apixaban, I was told I needn't stop but I omitted morning dose. Told dentist after extraction and he said good job I did as quite a bit of bleeding. Next time did the same and different dentist said don't restart till following evening. Compared with surgery it's avery short time to be off it.

Snowgirl65 profile image
Snowgirl65

I stopped my anticoagulant (Xarelto) three days before oral surgery, then continued back on them the night of the procedure.

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