Dental appointment - do I have to stop Apixaban

[gemsmum]

I have to have a wisdom tooth out next week. The dentist said to check with my Dr if I needed to stop Apixaban. I checked today with my Dr and receptionist rang to say Dr said it was up to the dentist as they have their guidelines. Now I don’t know what to do as it seems neither of them want to take the responsibility of telling me to stay on it or stop taking it for a certain amount of time. I would be grateful if anyone could tell me if they stopped or continued taking it. Thank you

[Drkrugs]

I am a dentist in the US. I also take xarelto for Afib. I refer wisdom teeth extractions to specialists in Oral Surgery and they will almost always discontinue the blood thinners before the surgery. It is up to them or the dentist doing the surgery. The one thought I have is if it is a discretionary extraction then maybe they want to assess the risk of stopping it for a short time vs leaving the tooth. Can you request a referral to a specialist if your dentist isn't aware of the protocols?

[wilsond]

I've had wisdom tooth extraction, told to stop Apixaban morning dose,then morning extraction and continue Apixaban that night. No problem. Packed tooth site well. Ps make sure non adrenaline pain relief

[CDreamer]

My dentist will always refer to specialist for that type of extraction. I just had surgery on my face and didn’t stop Apixaban and wound didn’t stop bleeding for days - until I missed my evening dose of Apixaban. As it is x2 daily I would not take my morning dose on the morning of the surgery, as wilsond suggested.

I had root canal surgery by specialist dentist and missed morning dose of Apixaban and dental surgeon gave me 5mg of prednisone to support healing because I couldn’t have Adrenaline in local anaesthesia. Adrenaline does reduce bleeding.

If you look on NICE guidelines they have a section for dentists so refer your dentist to that advice and it is up them to take responsibility.

[BobD Volunteer]

I take warfarin and never stop for dentistry but wisdom tooth may be deeper. I would never advise one way or the other but there are some suggestions for you to help your decision making.

[108cat]

I have no experience or advice on extraction and whether to stop Apixaban but would say as others have, and as you may know already .... to avoid any adrenaline based anaesthetic such as Lignocaine which can trigger AF. There are alternative types of anaesthetic that dentists can use.

I hope you find an appropriately qualified medic to answer your question on the anticoagulant ...

[Blearyeyed]

Does your dentist know about which medication you take.Even if they do , ring up and remind them and ask the receptionist to check with them if they want you to stop taking any of your medication before your extraction, or whether you might need an oral surgeon because it's a wisdom tooth and you have other health issues.

Dentists often have different opinions on this these days , although they are usually more careful with medication like Warfarin.

As people always used to get advised to stop an anticoagulant before an extraction you can also decide to make your own choice to do so even if your dentist says it's fine.

Always double check on the day of the extraction that they have organised anaesthetic without adrenaline. They should have but it's good to get them to double check before they inject just in case , mistakes can happen.

[50568789]

The consequence of following dentist advice and not stopping rivaroxaban before a single root extraction was continuous bleeding and a nightmarish 5 hour wait in A&E on a Friday night.

[Lifford]

A month ago I had to have two adjacent teeth extracted, which included a wisdom tooth. I phoned my GP prior to the extraction for advice which he/she refused to give and told me to consult with the dentist as it was up to them. The NHS locum dentist insisted I didn't have to stop taking my Apixaban. I found it almost impossible to stop the bleeding, which in part may have been how I applied and fiddled with the swabs I was given. In the end the dentist stitched my gum which did the trick. It seems advice varies which is a concern.

As an aside, I have been told that taking apixaban can cause or exacerbate receding gums. My gums have certainly receded more rapidly since starting to take Apixaban which may just be a coincidence.

[gemsmum]

Thank you so much for your replies. I have decided to ring the dentist and say my GP didn’t want to give advice! If she has no further advice I have decided to stop the morning dose as my appointment is at 11.30am. I am dreading it but it has to be done!!

[Alicant]

same happened to me….but many questions I ask doctors and other health care providers…same response “I can’t tell you what to its up to you”

[Sixtychick]

I have never stopped my Edoxaban when I’ve had an extraction and I have never had much problem with lots of bleeding afterwards. The last tooth I had out, last year, had a curled root and the dentist had a quite a lot of trouble getting it out, but the socket was packed with gauze afterwards, which stemmed the bleeding.