Apixaban and dental treatment.

[Rotsky]

Hello to all,

I need a tooth extraction and will welcome any info re: anticoagulants.

Would also like to thank those of you who are always ready with help and understanding of members queries and who are supportive to those in distress

[BobD Volunteer]

If your dentist is up to date with things they can advise but generally eithr carry n or stop gteh day before and resume straight after.

[Rotsky in reply to BobD]

Thank you Bob D x

[Rotsky in reply to BobD]

Just to say a big ‘Thank You’ to all who shared experience of dentists and anticoagulants. It is all over, no drama and not as horrendous as I was imagining. You are all so lovely and make life easier. Am not very good with the format so hope have put this in the right place. Again thanks…VJ.

[Hidden]

Click on the link below and scroll down to find the the NICE guidance relating to dental and medical treatment for patients who take Apixaban.

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

[oscarfox49]

I'm on 5mg twice daily but although it causes a few problems in dentistry such as excessive bleeding, this is no real problem. The bleeding stops normally but the dentist needs to use extra measures to take the blood away when working. Even with an extraction you are not likely to bleed so seriously that it will represent a threat to health. Just rather messy! You could of course stop taking the apixaban about 12 hours before treatment, but it depends on what kind of risk that presents to you and the degree of AF you are suffering from.

[exmouth]

Hi I take Apixaban, when I had a tooth out last year they just told me not to take my morning dose. I’m sure your dentist will advise. I was fine just took my evening dose as usual. I’m sure they’ll advise you before the extraction Take care

[Ducky2003]

I had a tooth out about 3 weeks ago and had to speak to my cardiologist/EP about what local anaesthetic I could have. Usually have adrenaline free but this was a hot tooth and wouldn't numb for previous work.He advised me to stop the Apixaban for 24 hours prior and restart that evening, if the bleeding had stopped.

Dentist was surprised at that but as it was still bleeding a few hours later, I was glad I had taken the EPs instruction.

[pusillanimous in reply to Ducky2003]

If the tooth is infected the local will not work - didn't you have a course of anti-biotics before any treatment.? I hate hearing of a tooth being extracted when mostly they can be saved. I guess I'm just paranoid.!

[Ducky2003 in reply to pusillanimous]

This tooth has been "hot" for a couple of years. Very sensitive and painful on and off as the nerve was grumpy. When I needed a replacement filling last year, it refused to numb up with adrenaline free local so I had to suck up the pain of the procedure.

No infection had been involved until this flare up. I had 4 lots of antibiotics leading upto the extraction and still had an abscess.Dentist wasn't able to do root canal work as there would not have been enough tooth left to crown.

He used Articaine this time, which is low adrenaline. Wasn't 100% pain free but better than the adrenaline free. No adverse heart event with it.

[pusillanimous in reply to Ducky2003]

Did he not consider building a pinned core once the root treatment was completed and placing a crown over that - I've had one and it worked well,?- I don't live in the UK anymore, but it really annoys me when I read about the NHS, doing cosmetic surgery and treating everyone walking into the country medically for free, but they cannot put a little bit more money into dentistry so you can have the best treatment. Are you now expected to walk around with a gap after that extraction or will they offer you an implant or a bridge? I don't live in America , but I realise why they laugh at British dentistry!

[Ducky2003 in reply to pusillanimous]

I'm a private patient rather than NHS.I have had a post and core done previously on another tooth but that did weaken that tooth so I think he was reluctant to to try that again.

It's right at the back so at least I'm not walking around looking like Steptoe 😁.

I can have a bridge under Denplan but implants are not covered by NHS or private dental plans, unless you lose a tooth through injury.

I'm reluctant to have a bridge as that would involve crowning the teeth either side of the gap, thus weakening them.

He did mention a implant but I'd have to wait 6 months for the bone/gum to settle so I have a chance to see how the chewing situation goes.

However, when he said how much they cost, I said it would be cheaper to buy a blender 🤣.

[Rotsky in reply to Ducky2003]

So agree re Steptoe, my gap is now Steptoeish but don’t care right now. Didn’t know about the aenesthetics but don’t like pain! Implant cost horrendous and also scary! Good luck with your decision. My old bridge was Denplan years ago but prices up a lot now.

[Ducky2003 in reply to Rotsky]

With Denplan, you just pay the lab fees for a bridge so a couple of hundred quid as opposed to £4000 private or £1000 NHS. Only other option was to have it out I hospital under GA to manage the pain situation but my EP said he'd be more concerned about that than a bit of adrenaline in a local.

[Rotsky in reply to Ducky2003]

GA sounds grim! I was in Denplan before I moved now looking for a suitable dentist to continue here. Denplan is worth it.

[Ducky2003 in reply to Rotsky]

I've been in Denplan for about 20 years. I have hygienist visits every 3 months rather than 6 months so I make sure I get my moneys worth 😁.

[pusillanimous in reply to Ducky2003]

Implants are worth every penny. I've got a mouthful that were done 15 years ago - the important thing is home care and correct insertion. A three unit bridge does not place too much stress but a gap allows movement of neighbouring teeth into the gap, so go for it. I was PA to the Professor of Oral Rehabilitation at Pretoria University who also commuted between private practices in Durban and Cavendish Square, London, so I have been brainwashed that to lose a tooth or have a gap is like having a death in the family, Ha, ha, ha.

[Ducky2003 in reply to pusillanimous]

Ah, yes. I remember you responding to one of my comments a couple of months ago. 😊.To be fair to my dentist, he hates having to remove teeth unless he has to, so I trusted that he had covered the bases he could until it had to be done.

I think I'd be more likely to go down the implant route, even though its a lot more expensive....... looking at somewhere between £2400 and £4000 😳.

[pusillanimous in reply to Ducky2003]

Do it !!!!!

[Dudtbin]

dentist should use adrenaline free an anesthetic and can pack the socket with a sponge which stops bleeding.

[dixiedad]

I need a colonoscopy and my gastro wants me off of Eliquis for 3 days prior.

[Anenome5]

I’ve just had a tooth out in UK and I was advised by several doctors to come off blood thinners 48 hours before. I was nervous but all ok. It’s so frustrating that everything to do with A fib gets totally different answers to questions from different drs.

[Rotsky in reply to Anenome5]

Do so agree!

[DawnTX in reply to Anenome5]

I have been taken off anticoagulants for as much as three days and for as little as one. One doctor did not have me stop it. Yes it can be confusing. I wish they would come up with a standard. I do know looking at my records that they actually test your clotting. Etc. when you’re getting surgery. It took me three times the normal time to start to clot. They actually kept me overnight. We are all different again. Stay safe.🙏🏻

[FraserB]

That's been my experience as well. The basics doctors will agree on but from there it branches out to totally different answers to questions from different doctors. "Electrical" heart problems are fast, evasive and not predicable unlike a blocked artery.

[DawnTX]

It wouldn’t hurt to reach out to your doctor to find out what he wants you to do. They also want to put you on an antibiotic usually before dental work. I guess it depends what type of dentist you have a dot your i’s and cross your t’s. Your dentist might tell you, but personally I would prefer my heart doctor tell me what to do. He is a specialist, and that for a reason. People on here also have mentioned avoiding some thing to be given to you, because it stimulates the a fib. Maybe someone else on here can tell you about that.

Best of luck. I hate the dentist.😱

[Rotsky in reply to DawnTX]

Thank you. Given antibiotics prior to next appointment. So many differing views and I suppose we have many different problems. x

[DawnTX in reply to Rotsky]

Absolutely no one size fits all when it comes to MEDICAL a fib is quite contrary. The antibiotics for dental has been a rule here in the states as long as I can remember. My dad had heart issues and I remember him needing antibiotics before a procedure. The last thing we need is any type of infection in the area of the heart and when you think of teeth and bacteria It makes sense to me. I know the other thing is some type of adrenaline that goes into some dental medicine used and again you don’t want that when you have a fib. It’s not a view. It’s common sense. We are not cookies and even cookies. Come out of the oven each a little bit different 😊 I am going to need major dental. When I had my first afib event, I blacked out. I went facedown on my concrete floor. Yep it’s not pretty. I have to have them all out because my top teeth have been relocated to where they don’t belong further up. I have had my a fib, interrupt, back surgery and my dental because they both require general anesthesia. Also my doctor does not want me having surgery at all unless it was an emergency surgery. Someone previously mentioned that you don’t bleed all that much from an extraction but again, that is something that should not be assumed. They have discovered it takes me three times the regular amount of time to start clotting. Again we are all different and even the doctors don’t always know until they get to it.

Good luck isn’t everything just such a fun adventure when you have a fib lol I just roll with it