Warfarin and Dentistry

Today I encountered a new twist on anticoagulation and dentistry. I guess we all know that dentists want our INR to be lowered before invasive dental surgery such as extractions. In fact their code suggests it must be below 4.0. Today I arranged to have an extraction next week and my dentist (in Sheffield) told me that he has received a new code of practice which says that he must have official, written confirmation of INR which was tested not more than 24 hours before surgery in order to proceed. He will accept a dated printout from an approved testing machine.

If, like me, you use the Coaguchek XS machine to self test but don't have the CoaguChek XS Connect device to produce an official, dated printout you have a problem.

Today I have ordered the "connect" device which comes with the necessary software to produce an acceptable printout from my home printer without which I imagine I would have to take my machine and test my INR in his presence!

Keep brushing those teeth well!

[Hidden]

Oh PBirt, why do they make life so difficult for us patients on anticoagulation but thank you for the warning. This new policy is going to cause major problems for patients on anticoagulation but for us who look after our own well-being and self-test can work round the problem but you will need to buy the Connect Device.

Luckily, I have the CoaguChek XS Connect Device, so thank you for the update. Keep smiling!!!

[armitaged]

Thanks for the information, how else would we find out about it?, who knows, i doubt that GP's will circulate it, (if they know about it) so the responsibility will probably be with dentists.

I haven't got a Connect device but see from Googling that they are available at £65 for those on long term warfarin.(excludes VAT or £13), 3 to 5 days delivery.

Unfortunately it could put even more people off self management/monitoring due to a combined cost..

[Tipper]

Surely if you are self testing/managing then all you need to do is take your Coaguchek with you and show him your latest test result which is in the memory? Or do a test immediatley prior to your treatment?

What's more important about dentistry is the possible need for antibiotic cover for when they draw blood! My heart problems were caused by endocarditis which took 9 weeks in hospital to cure and required replacement of my destroyed mitral valve and repair of my tricuspid valve. At the time I was recommended to have all my teeth removed to prevent future infection which I refused to do!

I was advised to take antibiotics before dentistry until about 2 years ago when the NHS/NICE said it wasn't necessary anymore. I challenged this with my cardiac consultant and he agreed that as I had already been seriously ill with endocarditis then it was preferable for me not to get it again! Antibiotics are still prescribed for me before any invasive medical procedure.

[flowerpower21]

Hello PBirt and All, I feel that things are becoming a constant battle for those of us who self test/monitor. What other obstacles are the medical profession going to expect us to leap over? Perhaps we should set up a Warfarin Olympic Games and see how far we can get with these constant challenges? This is yet another obstable of which will surely put more people off going down the route self test route because of further £ outlay. It is hard enough battling with my PCT (Dudley) to get the test strips for my XS machine on prescription... Like others I self test for convenience... I am one of many people who in this day and age (are lucky to have a full time job) only get paid for the hours they work and money is tight. I am unable to make up time for hours spent attending a Warfarin clinic and then making my way into work... it all addsup and it is a cost that I can not afford to take on! As Armitaged has commented - I bet the GP's don't even know about this... then again - a lot of GP's seem to not like the 'Self Testing' process (mainly because they have to wrangle/battle with the PCT)...so what do they care! Self testing isn't a luxury it is for the majority of people a life necessity... perhaps the PCT, Doctors and so on should open their eyes to this and stop trying to discourage patients from taking control of their lives! I think the next time I visit my dentist I will just do a test on the day and take my XS machine to show him the results....

[ELCgirl]

This makes me think hard about if I want to ever self test .

[Hidden]

Believe me ELCgirl, the benefits far outweigh the obstacles however frustrating they may be. Don't be put off self testing. The fact is that the obstacles are even greater for many of those whose testing is managed by "the system".

[Tipper]

The primary obstacle is ignorance by those who claim to know what they are doing!