clopidogrel

[Jantech]

Help needed!

Do I stop Clopidogrel before tooth extraction? Who do I ask? No one seems sure? Many thanks in advance.

[Ageingfast]

Dear Jantech

Yes, you will need to stop your Clopidogrel for some time before a tooth extraction. Ask your dentist for confirmation and for the length of time before the dental procedure. Please ask well in advance as the dentist might want you to stop for quite a few days.

I love my clopidogrel, but it is a problem for anything that breaks your skin.

Sooty

[Taviterry in reply to Ageingfast]

The current thinking is "Do not alter your anticoagulant or antiplatelet medication for dental treatment unless told to by your doctor, specialist or dentist". sdcep.org.uk/media/ivibjpvw... A few years ago the advice was to pause such medication a few days before treatment, but nowadays it seems to be not to. A couple of months after my TAVI, I broke off a tooth and my dentist was very reassuring, saying there was no need to extract the stump yet, and when it did come out there would be no need to stop Clopidogrel; my on-line checking confirmed this.

I take Clopidogrel in the morning and I suggested that I could alter this to the evenings (so it would be after the extraction), but the dentist smiled and said that wouldn't be necessary, adding that he had a number of patients on anti-coagulants and the like.

[Jantech in reply to Taviterry]

Very reassuring thanks.

[JCDBARBRIDGE in reply to Jantech]

Talk with you r GP or Heart team at your hospital, it’s unfair to ask members on this site we do not know of your medical history

[Marymara in reply to Taviterry]

I also understand this to be true.

[Maxwall47 in reply to Ageingfast]

It's about ten days before your proceedra It's bit worrying I know I've had 3 clots myself

[Lowerfield_no_more]

Ask your dentist. It is likely you will be asked to stop taking Clopidogrel a few days before. I was told to stop my low dose aspirin, which fulfills the same function, a few days before a tooth extraction, just as I was for other invasive medical procedures at the hospital.

[Jantech in reply to Lowerfield_no_more]

Thanks so much

[JennyRx in reply to Lowerfield_no_more]

My dentist did two extractions and said I didn’t need to stop low dose aspirin. And it was ok.

[Happyrosie]

my dentist said don’t stop it. Heavy Bleeding continued for 24 hours, however. And stopping would have to be several days before the procedure.

Was told bluntly “stopping risks heart attack. Not stopping risks heavy bleeding. Up to you”.

If you don’t get an answer from the professionals then my non-medical suggestion would be to continue with the clop and ensure you:

1. Have someone with you for at least 24 hours

2. Take note of the dentists recommendations about packing the tooth and follow to the letter

3. Do nothing that makes your heart work faster. So, if you do go out, be accompanied and walk slowly.

I stress, this is from a non-medical perspective

[Jantech in reply to Happyrosie]

Thanks so much.

[Lowerfield_no_more in reply to Happyrosie]

"...stopping risks heart attack. Not stopping risks heavy bleeding...." !!!

The first part sounds a bit OTT to me. Surely taking anti-platelets doesn't prevent people having a HA, since many who do unfortunately still have them, because there other factors that come into play in addition to blood clotting. It's just down to reducing the overall risk. But the comment implies that stopping an anti platelet increases the risk significantly. However in my view whereas stopping an anti platelet like aspirin or clopidogrel for 2 or 3 days for an invasive procedure which may involve bleeding will increase your risk of a heart attack to some degree, in the overall scheme of things the risk increase doesn't really amount to very much. Its very much on a par with stopping a statin for a few days, where the effect slowly goes whilst you have stopped and a short term risk with increased cholesterol load applies but which overall doesn't amount to much similar to an occasional naughty food binge, but not the same as stopping medication where the impact will which become very noticeable the day after, as I have found out when I occasionally forget to take my PPI for reflux disease.

[Jantech in reply to Lowerfield_no_more]

Thanks so much, it is close to how I feel as I haven’t had a HA or stroke.

[Happyrosie in reply to Lowerfield_no_more]

This was a slight paraphrase of what GP said - he put it slightly more politely but this was it in essence.

[Milkfairy Heart Star]

I am on clopidogrel for life.I agree with Taviterry's advice.

I had to have a tooth extracted a few years ago.

My Dentist told me to continue taking my clopidogrel.

I didn't have any problems.

I had to stay in the surgery for a while after the extraction for observation.

I suggest you check with your dentist whether to stop your clopidogrel

[Jantech in reply to Milkfairy]

You are so kind, thank you.

[Danny462]

I had tooth out a couple months ago my dentist wanted me to stop aspirin and clopidogrel on morning of extraction and day afterwards. But you should get advice from your dentist.

[Allyboy1973]

I Made my Dentist aware of my medication when i got a tooth removed though , i never stopped mine . I Don't know if different dentists do things differently .

[Jantech in reply to Allyboy1973]

Thanks so much.

[Mentdent]

I’m a dentist. Don’t stop the clopidogrel unless your dentist tells you to. We can always stop post extraction bleeding. We have lots of kit especially for that. Just make sure your dentist knows that you’re taking anticoagulants.

[Jantech in reply to Mentdent]

Thanks so very much.

[Jantech in reply to Jantech]

More terror.

[Susangibbons in reply to Mentdent]

My moneys on this guy!

They know exactly what they are talking about.

The rest are opinions only, and vary so much 🤔.

I am on apixaban and didn't have to stop before an extraction , this was on order of my dentist.

Hope it all works well 😁

[Jantech in reply to Susangibbons]

Thanks so much.

[Quesswho]

Because of the risk of bleeding, you may need to stop taking clopidogrel for a short time before having surgery or dental work. Do not stop taking clopidogrel without first talking to your doctor or dentist.❤

[Vjwuk]

My husband didn't he was fine, Dr said no need we checked.

[Jantech in reply to Vjwuk]

Thanks to you

[MountainGoat52]

I had two wisdom teeth extracted while on anti-platelet medication and didn't stop taking it, but the dentist would only extract one at a time. I experienced no issues with bleeding.

[Jantech in reply to MountainGoat52]

Eeek! Thank you so much

[jerry12953]

This conversation only goes to show the differences in opinion between individuals; some do, some don't. It appears that the same goes for dentists on whether to stop anticoagulants before extractions, and exactly the same is the case on some issues for GP's and even consultants. If only it were possible to be objective!

[Milkfairy Heart Star in reply to jerry12953]

Clopidogrel isn't an anticoagulant, it's an antiplatelet.

[maggie80]

Hi, phone the doctors or ask your dentist.

[survivorsguilt]

obviously you ask your dentist

[Sanmo]

I was on Brillique and Asprin, informed the dentist before an extraction and was told not to stop them. I was kept in the chair for about 15 minutes afterwards and checked several times for clotting, dentist let me go when she was fully satisfied all was well. No problem at all.

[piggybank1]

I recently had a tooth extracted at an NHS hospital and was assured no need to stop taking Clopidogrel. After the tooth was extracted they applied at stitch and a very small amount of bleeding. Within 24 hours no evidence of bleeding whatsoever. Just be guided by your dentist as Clopidogrel very common and I’m sure they’re very familiar with treating patients.

[Jantech in reply to piggybank1]

Thanks so much

[Blackcat99]

A few years ago, was told to stop clopidogrel for two days prior to an extraction but last year different dentist said no need to do so - and I had virtually no bleeding, other than at the actual point of extraction! No rhyme or reason?

If you can’t get advice from proper sources, maybe avoid taking on the morning of extraction itself? Good luck!

[Jantech in reply to Blackcat99]

Thanks so much.

[Gfern]

I would ask the Dentist doing the work, it is their responsibility for your care. If they don’t know find another Dentist is what i’d do.

[wischo]

My cardiologist told me to stop my edoxaban the morning of the procedure and start the morning after. My dentist said leave it the day after the extraction but I went with the cardiologist. My tooth extraction site weeped for four days, not badly just annoying. Yes different dentidts different opinions.

[Milkfairy Heart Star in reply to wischo]

Edoxaban is an anticoagulant, clopidogrel an antiplatelet. They work differently.Which is maybe why you were given this advice.

[Hrty]

I had a tooth out a few months ago without stopping clopidogrel or aspirin. Dentist was happy to proceed and said he'd be more concerned if I was on Warfarin. Was fine and had no problems but best to check with your dentist/cardiologist/GP

[momander]

I have had a tooth extraction and have not stopped any of my medication. I go by the advice of my GP and cardiologist. None of us are really allowed to give medical advice on this site as it may well be wrong. I would ask your GP

[LylaR]

I had a tooth out not long ago and dentist was confident not to stop clopidogtel as she said they have things in place inncase of excessive bleeding. I had no problems..

[ROBBO36]

I got my wisdom team extracted privately last year under general anaesthetic, the dental surgeon liased with the cardiologist and I had to briefly stop taking it. Looks like you’ve been given lots of good advice on here.

All the best with the extraction.

[Youghurtlover]

Hi Jantech,

I believe it’s perfectly fine to have tooth removed while still taking clopidigrel ,as I had 2 teeth removed while still on it ! Hope this helps X