EXTRACTION OF TOOTH WHILE UNDER HEART FAILURE

[Vivi2711]

DEAR RESPECTED COLLEAGUES,

Under DCM for nearly 10 months. Administered with beta blockers, diuretics, anticoagulants (clopidegril 75 mg daily) losartan with potassium. Recovered far better after 6 months. Though there is no symptoms as of now, my LVEF is 33 % ( has come down from 39%)

In the meantime having tooth problem. Dentist wants it to be extracted.

What are the repurcussions? Can I go for an extraction while taking clopidegril 75 mg daily?

Will administering local anesthesia suit heart failure patients?

Kindly enlighten me please 🙏

[Chappychap]

I've been surprised at the inconsistencies governing dental care for heart patients. You'll hear different things from different dentists.

I knew I had some imminent dental work when I went into hospital for an angiogram, the results of the angiogram were surprisingly bad so I ended up having an immediate heart bypass operation. About twelve weeks post op I was experiencing some tooth pain so saw my dentist, she advised a couple of fillings but said she couldn't give anaesthetic until six months post op, so I had the fillings the old fashioned way...ouch!

Shortly after I changed to another dentist in order to have a tooth implant done privately, the new dentist did an extraction and said she wasn't aware of any six month rule and used anaesthetic, neither dentist was concerned about by medication (I thought they may want me to pause with aspirin) although I don't take clopidogrel so I can't comment there.

One point to be aware of, after the extraction I had a problem called "dry socket" where a clot either refuses to form or gets knocked off. It's apparently more common when you're on blood thinning medication (although still by no means inevitable). You'll know if you've got it because the residual discomfort will subside on the second or third day, but then return with a vengeance on the third or fourth day. If you experience that get straight by to the dentist because you'll need to go onto a course of antibiotics.

Good luck!

[Vivi2711]

Thanks for the valuable guidance Chappychap