I appreciate this may be trivial in the face of other posts on here but I'd appreciate any thoughts you may have.
I take statins & Clopidogrel following a slight stroke 10 years ago.
My dentists have advised I should keep taking both ahead of having 2 teeth out. They will apply stitches at the removal sites instead. The leaflet with the Clopidogrel says to desist for a week before any surgery including dental.
Perhaps having teeth out doesn't count as 'surgery'?
Has anyone had any experience they are willing to share?
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Flyerswife
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The protocols surrounding stopping anti platelets or anti coagulants before and perhaps after dental work which may involve some bleeding seems to be variable from what I have read on here, as in some people report one thing others something else. Perhaps it relates to the anticipated degree of bleeding. Anyway the latest guidance to British Dentists is here apparently, and skimming through it, it appears your dentist is following the recommendation which says there is no need to stop your Clopidogrel, but that it may be subject to some precautionary measures.
Until quite recently, advice was often to pause Clopidogrel before dental work like yours but now it seems to be to continue with it, as the risk of clots outweighs the risk of excessive bleeding. This is something I looked into 15 months ago when I broke off a tooth within six months of having a new heart valve. I gather that dental work should be avoided during that period, and my dentist confirmed that the stump was unlikely to cause infection just yet; he looks at it every six months.
I've been on statins for 15 years or so and have never been aware of any suggestions they need to be paused before treatment. Every time I visit the practice I'm asked to confirm what medications I'm on. In 2019 I had several extractions without my statins being mentioned.
When I do have the extraction or any other dental work likely to cause bleeding, I shall ask my dentist about padding over the stitches and would I need to replace it if it becomes soaked.
You don't need to stop the statin , but advice differs for antiplatelet/ anticoagulant medications depending on what sort of dental or non invasive surgery you are having these days.If the dentist says it's ok , it should be, I think it also has something to do with which type of teeth you are having out and how many.
You could ask for more advice from your cardiac nurse , the BHF helpline or your GP , giving them details of the extent of the work you are having as they may be able to assess things more and guide you.
I've heard of some people continuing them but changing the times slightly , but it comes down to what your individual needs is not just the guidelines as far as I know .... In other words , typically confusing.
the “half-life” of clopidogrel is everal days. Stopping for, say, two or three days before a dental procedure won’t make any difference to the bleeding, I’m told.
I had a back molar removed because of an abcess a couple of years ago.
My Dentist said to continue with my clopidogrel, which I am on for life.
I was the last patient of the day. After the tooth was removed, I had to bite hard on a pad until the bleeding stopped.
I was kept in the dentist chair for about 20 mins minutes, then I had to stay in the surgery for a while afterwards.
I had to be picked up by my husband.
I was sent home with a supply of cotton pads and given instructions about what to do if I started bleeding from the toooth socket and general aftercare.
The risks associated with stopping clopidogrel far outweigh the risks of post op bleeding. Dentists are well used to stopping bleeding in these situations. I was a dental surgeon for 40 plus years.
For an operation clopidrogel needs to be stopped for five days but I would think that if a stitch is to be used the bleeding won’t be excessive with a tooth extraction. BHF nurses maybe able to give more advice
When I removed my wisdom tooth, I didn't take any medication that day because the dentist said I will be placed on anesthesia for the procedure. After the procedure, the anesthesia wore off, the pain was out of this world, I took only the antibiotics, vitamin C and pain killers the dentist prescribed, when the clot had properly formed at the site where the tooth was removed after 3days, I got back on my regular cardiovascular medication. It was a moment of stress for me but I am fine now. Your dentist knows what is good for you and will guide you accordingly. Everything will go well.
I'm on anticoagulants and asked my cardiologist if I should stop before a tooth extraction.He said for any procedure I needed to follow the instructions of whoever was carrying out the said procedure ad it was that person's responsibility.
I was on an alternative med, dentist told me to take them as normal except the day of extraction .
Then restart either later that day than normal or wait till next morning.
Now on warfarin, asked the nurse if dr google was correct, she said the hospital or dentist would advise, but normally 3 days prior to surgery. To be honest anti platlet don’t thin bloods that much.
Statins are not anti platelet or anti coagulants, they control cholesterol .
I don't know what the answer is about whether you should stop the Clop before the extraction (that needs a Dr to decide). However, you do need to prepare for the potential that you will bleed heavily afterwards. I had one tooth removed and bleed heavily for 9 hours, ending up in A&E and things getting quite dramatic. In hindsight, I would still have done the same things as I needed the extraction because of recurring infection, but I would have asked for it to be done by the dental person at the hospital rather than our local dentist 80 miles from A&E. Good luck!
I recently had an extraction whilst on Ticagrelor as the hospital said I couldn't stop taking it. My dentist said they had guidance on work whilst on Ticagrelor so they would proceed.
They just had to stitch it and wait to make sure the bleeding was slowing before letting me leave. Also I had to rest for a couple of days. It did still take a good day before it stopped weeping with blood.
I am not sure what clopidogrel does, but I am on apixaban, an anti-coagulant, so I am guessing they both work to the same end, to prevent blood clots. I was at my dentist only yesterday for a check up and needed a minor filling. Afterwards I asked what would have happened if it had to come out because of the bleeding. Her reply was not to worry, apixaban doesn't bother them, they have a plug which goes into the socket to control bleeding, and stays there, as it is gradually absorbed. Might be worth asking your dentist if they use them.
I was in hospital awaiting a TAVI but had to have a tooth removed. That was done at a dentist close to the hospital. I'd been on Clopidogrel for a couple of years at the time and wasn't taken off it. The dentist had a problem with the extraction and, as a result, had to remove two teeth. The stitches were the type that disolve and didn't require removing. Bleeding was minimal and caused no discomfort.
Hi. I had Open Heart Surgery nearly 8 years ago, but since then, if I have any dental work done that will draw blood, I have to have antibiotics an hour before due to possible infection. The dentist gives me the antibiotics prescription and I have to take 6 tablets an hour before the dental appointment. My cardiology/surgical team sent an email to that effect to my dentists. Better to be safe than sorry - prevention is better than cure.Hope this helps.
I didn't stop my blood thinners, when I had an extraction although the dentist did pack the tooth as it took a while for the bleeding to stop.
I have had a couple of teeth out and just did not take clopidogrel that day. No problems , no stitches. I think the dentist just packed the gap a bit longer and waited till he was happy.
I was on anti-coagulants when I had my tooth out. My problem was with the clot - it couldn't form due to excessive bleeding. A clot should form at the extraction site almost straight away and if not, the so called 'dry socket' could develop, when the bone is exposed and it can cause dreadful pain, lasting for a few days. On reflection, I should have stopped taking my anti-coagulant meds some time before the surgery, should have consulted my doctor. But every case is different, so please don't take my word as Gospel truth. All the best!
I had a tooth out whilst on Prasugrel (an alternative to Ticagrelor or Clopidogrel). No issues with bleeding although dentist referred me to local hospital for the procedure which took only a few minutes.
I had to have the tooth out as my Angina was brought on during an attempted root canal filling, that could be why they referred me to hospital.
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