tooth extraction

[mastiff22]

I am about to have several teeth extracted and my dentist has insisted that I do not need to stop the Edoxaban. I and slightly concerned as every procedure I have undergone that involved potential bleeding I have had to stop any anti coagulation for a few days. Anyone got an opinion/ experience of this?

[Mrsvemb]

I had two teeth extracted a few months ago. I take Dabigatran which is twice daily and my dentist just told me to miss the morning dose on the day of the extractions. No problems with bleeding at all.

Another dentist told me to stop for 48 hours, which is a complete overkill and I told him so. The half life of Dabigatran is 12 hours.

Don’t forget to request injections with no adrenaline.

[Stentrunner]

I’m on Edoxaban too, and I’ve had an extraction without problem. Also have regular dental hygienist, including deep clean. When I was on dual antiplatelet (aspirin and clopidogrel) I’d have bled like a stuck pig, but with Edoxaban it doesn’t seem to be a problem. Hope all goes well! J

[CDreamer]

Never had to stop with the new anticoagulants, if you are worried if you get a morning appointment and take your morning tablet after the procedure? I think since practitioners have become more used to dealing with DOACs you will find that the advice has changed.

From a study

Conclusions

Patients taking warfarin had more bleeding compared to patients taking direct oral anticoagulants after tooth extractions. In patients taking direct oral anticoagulants simple tooth extractions can be safely carried out without altering the anticaogulant regimen with the use of local hemostatic agents.

[Desanthony]

I have had several extractions recently and a lot of bridge work and implants - still not finished another 4 appointments to go (!) and take apixaban. I have not been told to stop or miss a dose as I did years ago of my own volition and it made no noticeable difference to the bleeding afterwards. If you are wary ask your cardio team to advise.

[Nerja2012]

Back tooth removed, told to stop morning dose of Apixaban, no problem at all .

[Ducky2003]

Last year, I was told by my EP to stop the night before and then the dentist said after, I needn't have bothered stopping so who do you believe 🤷‍♀️

[jeanjeannie50 in reply to Ducky2003]

I agree with you Ducky, it's a muddled and confused world we live in these days!

[Ducky2003 in reply to jeanjeannie50]

Indeed it is Jean. Both experts. However, my dentist can be a bit ham-fisted at times so I'd rather err on the side of caution anyway. His name is Christopher Lee so I guess he likes the sight of blood. 🤣.

[jeanjeannie50 in reply to Ducky2003]

Oh dear! 😂😂🤣

[jeanjeannie50]

I take Warfarin and have never had to stop it for any dental work I've had done. Had a back tooth removed a few years ago. My dentist is German and his wife has AF so he understands the condition well.

Jean

[mastiff22]

Thank you all for the very prompt replies. I feel very reassured.

[Olgarabbit]

My husband takes Rivaoxaban. He had a tooth extracted, told by dentist not to stop but unfortunately collapsed in the night after the extraction as bleeding wouldn’t stop. The physician said he should have missed his dose for two days before and one after. He is on 20mg, unsure if this makes a difference.

[mastiff22 in reply to Olgarabbit]

Thank you

[2learn]

Also check the anaesthetic is non adrenalin which can encourage more bleeding

[Bagrat in reply to 2learn]

Adrenalin actually reduces bleeding as it constricts blood vessels ( this also keeps the local anesthetic more local.This is why non adrenalin versions wear off more quickly) Dentists have other ways of stopping bleeding so not a problem.

[2learn in reply to Bagrat]

Surprised at that, seems opposite to what my docs and dentists have told me

[Bagrat in reply to 2learn]

Adrenaline packs also used to reduce capillary bleeeding in many situations

[2learn in reply to Bagrat]

hi, I've been googling this and it does say at various points that anaesthetic with adrenaline is not recommended for patients with heart issues, because it increases blood pressure, heart rate, and may alter the heart rhythm.

I probably made an error about the bleeding, but have been told by my GP an dentist its not recommended for people with AF.

[Bagrat in reply to 2learn]

Various medical profs have said diff things to me but I ask for no epinephrine aka adrenalin.

[jeff1257]

Ive had two extractions and implants in the last few weeks; did not stop Eliquis. No issues. Having 2 more in a couple of more weeks and will stay on Eliquis.

[JOY2THEWORLD49]

Hi

If at hospital they are ready to act if necessary.

Several, makes me more cautious. Ask your Dr rather than the Dentist if out from hospital.

With 1 out I delayed the AM PRADAXA 110 that I take twice day.

cheri JOY. 75. (NZ)

[Desanthony]

The first lot of dental work (and believe me I need and have had a lot of dental work(!)) I was very worried and although the dentist and cardio said I didn't need to stop my apixaban I did. Since then I haven't bothered unless the dentist has told me to - which she hasn't so I haven't stopped it since then for simple extractions and I have had implants and bridge work done without having to stop.

[mastiff22 in reply to Desanthony]

Thank you so much. Very reassuring.