Just after some advice please.Im due to have a back tooth extraction and I take apixaban. My dentist ( a new one to me) didnt give me any advice about taking or stopping apixaban before the procedure. I told her about it and she just said that it should be ok, though I'll obviously bleed more than she would because she doesn't take it!
I have to say that she hasnt filled me with confidence. For those of you who have been through this, what is your experiences please.
My dentists has never asked me to stop anticoagulation in the 19 years I have been taking it.
Have you had a tooth out Bob? And if so, did it stop bleeding ok? I hate the dentist at the best of times, im such a baby.
Somebidy also said that to guard against infection to the heart, they should give antibiotics with an extraction?
Maybe a little longer but of course. He usually packs the socket anyway. Mind you I had one fall out last week and it stopped in about two minutes.
If you are worried about infection then speak to the dentist.
My dentists says that NICE guidelines now only recommend antibiotics if you have valve problems
Antibiotics kill gut bacteria that control blood electrolytes, that are protective against heart attacks if you have AF.
My AF just stopped after 26hours…
Regarding antibiotics, go on YouTube and type in: doctor thinks he knows what causes alzheimers, Parkinson’s, and ALS, mark Hyman.
It’s ground breaking on health, great 2 doctors and I’m now avoiding antibiotics.
I've had a lot of dental treatment including extractions and root canals and have never had to stop my Warfarin in the 20 years I've taken it. Bleeding has not been a problem.
I don't think that antibiotics are given out these days unless absolutely necessary, so not used as a prophylactic.
I had no probs at all with an extraction. He just allowed an extra few mins before leaving the surgery. My daughter is a dentist and says the bleeding rate is very low.
She did however recommend that I have an adrenalin free injection to reduce the chance of an AF episode. You might want to consider if not already aware. See forum discussion.
I know it is not the same but am having an op on Tuesday and have been told to stop the Apixaban 24hours beforehand and the Omega 3 as well. Mind you I know that either the nurses nor the surgeon have any experience of A/F patients. Do you all think what they said is about right?
I was told to stop my morning dose of Apixaban if I went ahead with an extraction, it has a half life of 12 hours.
In the end I was talked into a rout filling ,1.5 hours with my mouth propped open, how I wish I had chosen extraction.
Thats my option but as they cant guarentee a successful root filling due to there being a large filling in there already, ive gone for extraction. Thanks for your reply
I had two extractions 2 weeks ago. My dentist told me to miss the morning dose of Dabigatran, which I did. Bleeding was minimal.
I restarted Dabigatran that evening so only missed one tablet.
I have had an extraction without stopping Rivaroxaban, which I was on at the time. I did bleed quite a lot and found it disgusting. The socket was packed and I had rolls of gauze to bite on, but not pleasant.
Don’t forget to request the injection without adrenaline.
I had a tooth out last year and my dentist told me not to take my morning Apixiban before I went, still had some bleeding for a couple of days but otherwise it was fine 😊
There have been changed in protocol recently after more research into the risks of bleeding from dental work weighed up against the risk of not taking your anticoagulants and having a clot cause a problem.I've been checking this out recently because I've got tooth extractions coming up.
Current research has shown that the chance of heavy bleeding even on a DOAC is low , but that oral surgeons need to take the patients previous post treatment bleeding or infections , and other illnesses or medications that could affect bleeding or healing time as well before making a choice.
It appears , when you read the general guidance given in most NHS Trust areas to dentists that they are " hedging their bets" , which seems to be good for safety .
Most suggest the guidelines that MrsVemb, GrannyE and Doodles 68 have given.
To stop taking DOACs for 12 hours approx prior to surgery, which just means missing your morning dose and taking your doses as normal afterwards unless you have a problem.
As GrannyE also suggests some guidelines also mention stopping Omega3 if you are on it.
Most suggest that if you have AF it is better to make sure before the day and request that your dentist uses an anaesthetic without adrenaline just to make sure they have it in on the day. Unless , you also have another health problem which causes anaesthetics to last for a shorter time on you.
Making sure the area of extraction is packed for longer is also important, as well as strictly keeping up the self care protocol to be careful about what you eat and drink, nothing too hard or chewy , nothing too hot or cold . Swilling the area with Luke warm water after the healing clot has set and keeping the mouth very clean to reduce the risk of infection.
Fab thankyou
Well, I was told by both my dentist and GP to take my Apixaban as usual. I bled for 12 hours and was on the verge of going to A & E. If there's a next time I will definitely stop the morning dose......
I’m not on anti coagulants and had a tooth extraction 5 or 6 weeks ago. When she had removed the tooth she exclaimed that I’m a bleeder. However she managed to stop it fairly quickly by putting a teabag that she put in hot water, let cool and applied. Worked a treat and whilst I had normal seepage for the next 48 hours it wasn’t an issue. The upshot of this is just to keep that in mind as it’s a solution if it did happen and looking at experiences provided on here probably won’t.
my mum is on riveroxaban and has recently had her front bottom teeth extracted to have a denture fitted. She had no problems and was told not to stop her anticoagulant. She was fine maybe slightly more bleeding than If she didn’t take it but nothing significant
I didn't stop taking mine however ask your dentist for an Adrenalin free injection because that helps not to over stimulate the system
Hi
I have had two dental implants very recently involving an extraction and some gum surgery with stitches. I was asked to stop two doses , I did and it was fine. He asked me to stop the doses again for further gum surgery but I forgot! the bleeding was quite a lot worse and that was without an extraction
Jane
I've had a number of extractions in the last few years. I was told to stop my Edoxaban 24 hours before but the last one was a wisdom tooth so 48 hours. I've not had anti B's prescribed. The wisdom tooth and a molar were packed and stitched. No issues with any of them
I had to stop blood thinners 4 days before colonoscope. And had to get my cardiologist's release to do so.
My husband is on Clopidogrel and had a back tooth removed a few weeks ago. He was told beforehand that he wouldn’t need to stop taking it. He didn’t bleed excessively and it soon stopped.
I have not had an extraction since I started taking apixaban but I have had some fairly major dental work including the gum being cut in order to make a dental implant fit properly. The French dentist knew I was on apixaban and told me it was no concern. It did involve quite a lot of bleeding which was removed by one of their suction pumps, but it stopped fairly soon after the procedure. It did mean the procedure took longer than normal for the dentist. But apixaban does not stop you from being able to stop bleeding, merely that it flows far more freely.
they should have a clotting sponge to put in the socket to help with clotting. You must ask for adrenaline free anesthetic. I know we used to check warfarin levels before extraction but I don’t think we stopped any anti coagulants for a normal extraction. Each dentist will probably have their own ideas,. I was a dental nurse for a very long time.
Hi there, I had a tooth out a few weeks ago and I’m on warfarin. I have a very complex cardiac history so the advice I was given may not be correct for everyone. I had to reduce my warfarin for a couple of days before hand until my INR was at or slightly below 2 (it’s usually maintained at 3.5 - 4). I was given antibiotics before and after the extraction and also, had to inject myself to prevent blood clots a couple of days before and after. The tooth did bleed a little bit more than usual but everything went well. Although antibiotic cover is not usually given now, depending on your history, that might still happen. Hope that helps and good luck! It’s never nice having a tooth out
That sounds complicated, glad youre through it all
Hello. I’ve had a lot of trouble with my teeth (including extractions) and I’m still learning!
My dentist told me not to take the morning dose because of bleeding.
I also now ask for a numbing injection without adrenaline and, like you, I have read about bacteria from the mouth affecting the heart in a bad way, but when I went for a deep clean a few years ago, my dentist told me it wasn’t necessary to take antibiotics before the procedure.
Take care. 😊
I am on Edoxaban and my dentist was not worried about it . The back tooth extraction took 45 minutes but was successful with no bleeding problems. …😷
When I had a tooth out I had to stop my apixaban the morning of the procedure and restart morning and night the next morning. It only has a12 hour span so you will be fine.
Also my dentist has always recommended taking amoxicillin one hour before procedure. It is the one that you mix in water. There was a time that it was deemed unnecessary but my dentist said the teeth and any infections etc are closely related to heart so he didn’t want any of his patients to take that risk
If your dentist is not sure of all this, I think I would be worried about her competence. Sorry!
All the best
Now I take Flecainide regularly, it has stopped AF episodes so I stopped taking Apixaban but your dentist should know about it and treat you accordingly -I should think you might have to stop the anticoagulant for a few days before the extraction but do make sure. My husband had a tooth out yesterday. He isn’t on anticoagulants but the dentist checked before he did it as he did with me when I had one out some time ago. Hope it all works out well for you!
when pressed, my dentist said he would never advise about any such medication, it’s up to the GP.
I had a an upper incisor tooth out about a couple of months ago and it had a bent root, so the dentist I saw, which wasn’t my usual one, had a real struggle to get it out and was hacking at it so much, she damaged a bit of the bone round the socket, which I only realised about later on, when I felt this sharp bit in the gum and could see something white sticking out of it. I went back to the dentist and saw my regular one this time and he looked at it and said yes, it was a bit of bone and he managed to sort it out. I never had to stop my Edoxaban and it didn’t seem to bleed excessively. It was packed with gauze after the extraction. I have had an anaesthetic without adrenaline for many years, as I had a reaction to it in my 20’s and it made me feel sick and shaky and dizzy and it doesn’t mix with the drugs I take now anyway and adrenaline can cause heart arrhythmias in some people. Adrenaline free jabs work just as well and I’ve had a lot of my teeth extracted now unfortunately, but this was the first time I’d had that much trouble with an extraction. Still it’s all healed now and a new tooth has been added to my denture. I worked as a dental nurse, for 4 different dental practises, when I was younger, so don’t worry about visiting the dentist. I think the catheter ablation, that I had under sedation,6 weeks ago, was worse than the extration I had.!!
I had a back tooth extracted a couple of years ago. I take Apixaban . My dentist said I could take it as usual. Like Bob said maybe I bled a little longer ,not sure as I haven’t had a second tooth taken out before,but all was well. Recently I had an endoscopy and was told to leave out the early morning dose but to be sure to take the evening one. Again all was well.
Good luck ,I hope it is a smooth extraction .
hi
I Hav had 2 extractions of late.
I simply delay the anii-co.agulant for that day and get an early appointment.'
I am on PRADAXA X TWICE.
She said that they take it out at the hospital so that they have facilities if I did bleed.
The upper last tooth actually was out in 5 secs. What a surprise after all that humming agent.
You have reminded your dentist accordingly.
You'll be OK.
cheers JOY. 74. (NZ)
I had an extraction and was told to pause my morning dose of Apixaban-the extraction was at about 1100. It was difficult to get the information as neither the dentist nor the doctor wanted to take the decision-eventually the dentist took responsibility.
I recently had a tooth extraction, I take 5mg Apixaban morning and evening. Didn't stop meds and was fine. Dentist followed the usual extraction procedure (bite down on gauze in the cavity) and all went very well. Hope all goes as well for you.
Only once stopped apixaban for an extraction when I had only been on apixaban for a matter of months so was worried and there was absolutely no need to do so. My dentist told me it was up to me as did my GP and Cardio told me the same but if I did decide not to take it just to not take my morning tablet - my appointment was at 2pm and to take the evening one as normal. Since then I have had quite a few extractions implants and bridge work and continued on aticoagulation as normal with no problems whatsoever.
I've just had this done and the dentist said it would be fine, he just spent extra time holding a pad on the hole after the extraction to make sure the bleeding had stopped. It healed fine and I have had trouble with it. I'm on 5mg Apixaban and ancient so best of luck to you. x
Depends on how many teeth you need extracting. I am on Edoxaban and never had a problem and did not stop my medication. Dentists deal with this all the time. If its only one tooth you should be finew. Dentist just put a suture in my gum socket...Never had an issue
Dentists
dentist and anticoagulants 
”A bit of a do” at the dentist
Dentist and Apixaban
