A Tale of Four Teeth …. and Apixaban.

[Rosamoyesii]

Earlier this year, I posted my concerns regarding a forthcoming procedure where I had been informed that the dentist would remove four teeth and fit a cosmetic denture at the same time. All of the teeth were upper situated - one right in the front (which was a leaking abscess) and three, all close together, upper left. However, fate intervened and the leaking abscess on the front decided to do its own thing and become rather painful, the result of which it was removed, packed and stitched. All went well. Ha! I thought. One down, three to go!

March 13th arrived (how could I forget) and I duly presented myself as arranged at the dental clinic.

Before that, however: just to intervene here, one good thing has arisen out of all this. I discussed my dental fears with my doctor prior to the big day and he prescribed 2mg Diazepam, to be taken exactly one hour before I kept the appointment. I did as advised and one hour before leaving for my appointment, I took said pill. When I arrived for the procedure at 2.30pm, I remember entering the treatment room thinking that, this pill is not working. I don’t feel anything different. I seated myself and do you know all you guys who are Type-One-Dental-Phobic.com. like me, it worked. It just worked! No nerves, no fear. Just so laid back it was a revelation. Why didn’t I find this pill years ago! Anyway back to the Tale.

All was straightforward. I was told later that it was a difficult extraction, as the roots were large and tightly packed together and I was aware of the exertion required by the dentist to unseat them. But all appeared straightforward. The next step was to put in position the denture. No packing or stitching of the wound. Just the denture.

Drove myself home. Had some tepid cream soup about 5.30pm. Then almost an hour later, the extraction site started to bleed copiously. It continued to bleed copiously all evening, during which time I must have used up most of a jumbo kitchen roll! 10.30pm was a little concerned, as I couldn’t go to bed like this. 11.30pm phoned NHS UK emergency number for advice. (I live in Scotland). Had a calm conversation with two nurses at other end who kept telling me not to take second dose of Apixaban. I had stopped the morning dose. After fifteen minutes they decided to send me to the local A and E Department, which is fortunately only about 10 minutes distant. So after midnight, I drove myself, kitchen roll and all, to the hospital. The NHS gets a lot of adverse publicity at times, but everyone was wonderful. I was met at the entrance by a friendly greeting, ‘hello, we’re expecting you’, had my notes checked and then over the next two hours was seen by two different lady doctors - an hour with each one. They couldn’t do anything since the denture was in place and they didn’t have a dental unit, but I was given iced water to hold in my mouth and that did the trick in backing it off and they wanted to see I was ‘safe’.

Drove home at 2.30am. Starry sky, sparkling frost and the biggest snow plough I have ever encountered.

Had been advised by hospital to visit my dentist next morning. This I did, where I was seen by two dentists. They were genuinely most concerned and gave me a blank sheet to call or drop in with absolutely any concerns, at any time! But I was to keep the dental plate in position. 🤣

That was the Tuesday. Liquid food mostly Tuesday and Wednesday. Thursday same again, but at about 8.00 pm, the durned thing started bleeding again, going quite well. (I had re-started the apixaban Wednesday morning.). Well, I just decided to cope myself, so I did the iced water thing. At about 12.30am I just had to have some rest. Slept with clenched teeth for perhaps four hours. Got up at 6.00am and walked through to look at myself in bathroom mirror. I kid you not! I think I must have been participating in a Vampire Rave all night, as when I opened my mouth to inspect! everything was black. Teeth, tongue, every nook and cranny of the orifice was black! Right, I thought. Had enough! So very gently I removed the plastic denture, together with a several days’ accumulation of black debris. I carefully cleansed everything. The wound was still bleeding and I subsequently made a pad of some dental gauze and cotton wool and pressed it on the wound. I sat like that, in my pink pyjamas, for two hours and it stopped! I have continued to persevere and everything seems to have settled down. Sorry it’s long-winded, but hope the coping information may just help someone out there - particularly the details of the Diazepam. What a find! 😄

[jeanjeannie50]

My goodness what a story and you told it so well! It was one that I recognised a little as I'd needed a molar extracted but the root curved into the tooth next door. My dentist had to tug away for what seemed like ages and his next few patients were seen by another dentist. Afterwards I was given a pad to bite on and told if there were any problems to go back. Well I did later that afternoon, because it was still gently oozing blood, nothing like yours which was really bleeding. All I was given was reassurance and more pads to bite on. (with hindsight I think I was making a fuss over nothing). I just have a tooth missing at the back of my mouth now and never think about it. I've only ever had one wisdom tooth (says a lot about me).

It seems strange for your dentist to put a plate right on top of where he had just taken out teeth, but what do I know - precious little! It must have been a very traumatic experience for you at the time. Thank goodness it's all in your past now. It's a wonder we're all not insane with the various types of torture that we experience throughout life.

Take care.

Jean

[Rosamoyesii in reply to jeanjeannie50]

Hello Jean and thank you for replying. What you underwent with your entwined teeth takes a steady nerve. Something which I could not do since a horrible childhood experience. Well done you.

As for placing the denture over the wound: this is what formed the basis of my initial worries. How would a piece of plastic over a gaping wound work. Like yourself who am I to argue. When I returned the day after the event and the two dentists were there with me, I forgot to say in my original diatribe that they apologised and said they should have stitched the wound. They were genuinely concerned. I now wear the denture when I go out, but don’t use it at home. Needs more practice! 🤭

Thank you again for replying. Like you, I sometimes wonder at some of the routines we encounter which are meant to be helpful. I’ve learned a lot from this ‘adventure ‘. Good health to you. 😉Rosa.

[Ppiman]

Sadly, it seems that up to a third of people taking diazepam risk becoming dependent on it if taken longer term. This has made most doctors reluctant to prescribe this useful drug for people who suffer anxiety. I have to say that it isn't as effective with me and I need 5mg but it is still helpful and it seems to me very unfortunate that it has developed a bad reputation and is so often restricted,

Steve

[Rosamoyesii]

Morning Steve. You are so right about the pros and cons of taking Diazapam and I am well aware of the reasons for restricting the prescribing of this drug. As someone who has suffered life-long fear of any dental procedure, as a result of a devastating childhood dental experience, I was only too glad to resort to it as a prop in times of dental need and will only ever view it as such.

Hope you have a good day and thank you for writing and highlighting this important information. ☺️Rosa.

[Wildare]

That sounds bad. I only took Apixaban twice a day for a short period, as it caused tummy upset. In any event, I found the twice a day regime very irritating, so asked for a change to a once a day drug- and chose Edoxaban, once a day. Have had no problems since, and no bleeding difficulties.

I still get some tummy upset at times but nothing more and I take one pill at the same time every day.

Hope this helps.

Martin

[Rosamoyesii]

Hello Martin and thanks for your reply. When I first developed a fib I was put on warfarin, but it did absolutely nothing for me. I remember the doctor phoning me and suggesting changing to one of the more modern anticoagulants and adding, ‘which one would you like!’ My silence down the phone must have spoken volumes, because I didn’t have a clue about any of them. So he added, ‘would you like me to choose for you!’ That is how I landed on Eliquis. I don’t mind the twice a day so much, but I do agree it tends to lock you into a timed routine. Since starting on Apixaban I haven’t experienced stomach problems as such, but it does bloat me all the time. I’m one of these funny birds who tends to react adversely to all kinds of medication and my doctor knows that I will only ever take the minimum dose of whatever is required.

I think the main bleeding problem which occurred when I had the extractions was the fact that they didn’t pack or stitch what was effectively a gaping hole. They did apologise for this the day following the procedure, when I returned to a concerned reception. I had been told by the dentist before hand that the plate would act as a sticking plaster and and he reiterated to continue with it all week, night and day. I couldn’t see the common sense in this, but ‘obeyed instructions’. In the end, however, I did my own thing by resorting to my own common sense.

I have taken good note of your recommendation and will do some research on it. It’s always best to have personal recommendation. Thank you again for writing. 😉 Rosa.

[Tedrick]

Hi Rosamoyesii

I don’t think there is a general problem with Apixaban, apart of course with the side effects of which there are a few, I am a bit of a numpty at times so I may be wrong but bleeding can be one of the side effects and perhaps that is what the nurses were alluding to.

[Rosamoyesii in reply to Tedrick]

Morning Tedrick. I think you are quite right regarding the Apixaban. In my case, bloating is the main side effect for me and I am aware about the increased bleeding aspect. When I spoke to the nurses at A and E, during the evening after the extractions, they were quite insistent that I refrain from the drug at that particular time. I do feel that even had I not been on Apixaban, the wound would have bled copiously on its own, since it was such a large gaping hole. In fact, when the dentist viewed the situation the following morning, he let out a cry and asked his nurse to fetch his colleague from next door, as he’d never seen such a large clot! The mind boggles! 🤣

Thank you for writing as all opinions are welcome. ☺️ Rosa.