Tooth extraction

[Ope1]

Hi everyone 1yr ago i had heart attack now I'm on plenty of medication one of them its blood thinners and just wanted to ask for tooth extraction. Can anyone help? Thank you

[wattsy1985]

When i was on blood thinners the dentist decided to just remove the tooth, personally i think it took a lot longer to heal, i understand best practise is to stop the blood thinners the day before and leave at least 24hrs afterwards to try and allow the wound to clot. Just make your dentist aware and they should advise you on the best course of action

[Petercat1 in reply to wattsy1985]

Hi. With me, my Cardiologist gave me a letter for my dentist stating that I need antibiotics when having any work done that draws blood. My dentist has a note of my medication, but was never told to stop my blood thinners. My extraction point did bleed for longer, but I went back to my dentist and he just plugged the extraction site. Not sure if it's the same for you re antibiotics, but mine was a type A aortic dissection and open heart surgery and the antibiotics was to avoid any possible infection.Best wishes

Denise

[Ope1 in reply to Petercat1]

Hi Denise this was very helpful. Thank you so much.

[Ope1 in reply to wattsy1985]

Thank you for your reply. That was helpful

[devonian186 in reply to Ope1]

I was told to gargle twice a day with salty water. Very little bleeding and it healed quickly

[Cee-Cee1 in reply to devonian186]

After having had two molar extractions in January and February this year, my dentist also told me to rinse my mouth with salty water and not to use my usual Corsodyl mouth wash for a few days. I was really delighted, and very surprised, at how quickly my gums healed. I'd very little bleeding either.

[Nelson71 in reply to devonian186]

Standard practice for an extraction. Glad it went well

[Happyrosie in reply to wattsy1985]

I was told that stopping the thinners the day before doesn’t help - it has to be several days. If that is what you do - but the dentist knows all about this kind of thing.

[Morges in reply to Happyrosie]

i have to say my dentist did not have a clue about stopping blood thinners (anti coagulants) or antibiotic cover. When I recently went for hip replacment my surgeon told me to stop 5 doses of Apixaban which I take twice a day.

[Happyrosie in reply to Morges]

I am horrified by what you say!

Your dentist would know when antibiotics are needed - it depends on which heart problem you have, not all cardiovascular issues need antibiotic cover.

And they should know to advise about anticoagulants.

If I were in your position I would change my dentist.

[survivorsguilt in reply to wattsy1985]

PLease,please ask your dentist not us. Everyone is different.

[wishIwasbetter in reply to wattsy1985]

Hi wattay

funny thing had some painful work done yesterday with my Dentist digging out a root from a snapped tooth. I am on Apixaban twice a day. She said stop the morning one and leave the evening one until late. Worked a treat so just see what the Dentist advises. I had a little bleed but she stopped it with gauze much like when they take blood.

[wattsy1985 in reply to wishIwasbetter]

Hi, i guess its strange how everyone reacts differently, normally i heal really quickly but took me about 2 weeks to full heal from it, the only thing i could put it down to was the apixaban

[Lymebabe]

Hi, I've been on apixaban for 4 years now and during that time I've had four treatments for dental implants, three under conscious sedation. I was told to stop taking Apixaban the day before, and fortunately I had no problems at all.

The dentist commented that there was just 'normal' bleeding following each procedure and I healed very quickly.

[Eeee13 in reply to Lymebabe]

I was told exactly the same thing come off them 24 hrs prior to dentistry

5 mg of Apixaban only lasts in me about 12hrs that’s why they are taken every 12 hours. They can take effect in about 10 minutes.

[Eeee13]

Apart from blood thinners if your iron levels are good your body will clot quite quickly.

When I think of all the cannulas and cath tubes I’ve had in veins and arteries since beginning of last year. .

[Donny64]

I had exactly the same issue, the dentist was reluctant to extract without giving me antibiotics cover as there is a link with heart issues and infections from tooth extractions. He got confirmation from my cardio people and all was good. Had a dose of antibiotics immediately after extraction. Hope this helps

[bikerider00]

You haven't said what blood thinners you are on. Are you now just on low dose aspirin for example, or maybe on dual anti platelet therapy so including an anti platelet like clopidogrel? (e.g. because you had a stent fitted).

If the former, I would expect it to be fine. But you must tell the dentist and get their instruction. In the latter case, you should not only tell them, but if they ask you to stop the anti platelet you should be notifying your doctor of this and getting their OK for it. That was the general advice we were given by the cardio rehab team, (and the hospital discharge team).

If it was a year ago you had the spent, I would expect you to be coming off e.g. clopidogrel at 12 months if that was the sole reason it was prescribed.

Caveat: I'm not medical, just a patient.

[Ron0325]

I had a tooth extracted 2 weeks ago , I am on clopidogrel , dentist advised me to just continue my normal dose, bit more bleeding than normal but it was all fine , they gave me a kit incase the clot was dislodged , didn't need it , so nothing to worry about , you must inform the dentist of all the meds you are on

[NIPPS]

I’m also on blood thinners , I’ve just had a tooth extraction , and the dentist told me not to take a tablet the night before , and the morning before , there was hardly any bleeding at all , but obviously check what the dentist wants you to do before

[Vrouse]

I'm on Apixaban and was advised by my dentist not to stop but to also ask my GP who agreed. My tooth was extracted and bled heavily for 12 hours. The pain was causing the site to throb so it kept pushing out the clot. Next time I will definitely stop the Apixaban the day before.

[Christobel23]

My dental hygienist cancelled my appointment following ablation. She won't proceed until I have a letter from the cardiologist. Which surprised me. So am waiting for 3 month review and will ask then as I'm sure he is bit busy!

[Artemlos]

I was prescribed clopidogrel following my hear bypass operation a year ago, however it was only for 12 months and I have now stopped taking thst particular medication, though still on asprin and others for life

[Anothernewbie]

I am on apixaban, 2 x 5mg/day, which is an anti-coagulant, although referred to as a thinner. I mentioned this topic to my dentist very recently and her reply was - let us worry about that, we have plugs we use and it is not necessary to stop apixaban beforehand.

Without knowing what you are on and the dose it is hard to advise. It certainly would not hurt to ask you GP though.

[Blackknight57]

anti biotics prior to(normally 5 days) and withdraw from anticoagulant for 3 days. My range is 2-3. After 3 days without went to 1.3(top of normal range)

My practice doesn't seem to understand this.

Asked in another surgery by same company they told me what they normally do. Totally routine practice.

[Sixtychick]

I had a back tooth extracted last year and didn’t stop my Edoxaban. The. dentist packed the socket with a gauze dressing and got me to bite on it. I didn’t have any problems with excessive bleeding.Then after 24 hours, you can start rinsing your mouth out with salt water for about 4 days.

[fishonabike]

Dentist have guidelines on this and should check for themselves what the correct procedure is

Make sure you have clearly informed your dentist about your heart condition and your medication, in writing if necessary - ask them to tell you what steps you need to take before any dental procedures

It is their professional responsibility to check, and if necessary they should contact your doctor/s

[Airlie37]

Hi I'm on Apixaban twice a day and for a tooth extraction my dentist told me to mot take the Apixaban the day before and also the morning of the appointment x

[A2Z3]

I recently went to the dentist for a routine checkup, the first time since having a heart attack. She noted all the drugs I was on and didn’t think the blood thinners were an issue for future treatment (I’m on Asprin) but did mention the anaesthetic. Apparently the ‘Usual’ one contains adrenaline so she made a note on my record to use another type. Just hope it’s as effective 😂 make sure your dentist knows all the drugs you are on.

[Qualipop]

I'm surprised you're still on blood thinners a year after a HA. They are usually stopped after 12 months unless you have other problems that require them. You may like to ask your GP. They are not actually "thinners", they help to slow down clotting so it may take longer to st op the bleeding after an extraction. It's your dentist's decision.

[wischo]

I had an extraction and was told to stop Edoxaban that morning and the day after and my cardiologist advised taking a baby aspirin instead. He said you wont bleed out or anything like that but it can be very unpleasant and not unusual to bleed for up to a week afterwards if anticoagulation is not stopped. He told me the chances of anything going wrong from stopping the meds are really miniscule.

[Ruby300]

Hi, I had tooth extracted few months ago I am on blood thinners which the dentist already knew. But she said nothing about stopping them she took it out it was really strange it never bleed. Everything was fine.

[Ope1]

Thank you for your kind reply 🙏

[Mentdent]

stopping blood thinners is not normally advised. Routine extractions are not normally a problem. Antibiotic cover is only given in special circumstance. Ask your dentist. They are the people who know all about this stuff. It’s their job.

[Bobkins99]

My understanding is that if you've had heart surgery you need antibiotics. Generally you would stop blood thinners the day before and the day after unless you're monitoring INR

[Shabana1974]

I had 6 teeth removed last week on the 17th. I was told to stop Dapagliflozin 48 hours prior and Entresto not to take on day of procedure. They didn't stop my Aspirin. I will say I am still not healed yet so please expect a longer recovering period. They also put stitches in my extraction sites.

Hope that helps

Best wishes

[Ope1 in reply to Shabana1974]

Thanks for your reply. Much appreciated

[Jaybbb]

My dentist did the right thing and told me to ask my cardiologist what he wants. Although I have an excellent dentist, I would not leave that decision solely for him to make. I am on Tricagrelor (brilinta) since November 2024 plus a baby aspirin. My cardiologist indicated that I should not stop the antiplatelet medication and unless it is a dental emergency--wait until the 12 months are up. Since the medication is important in protecting the Stent, that approach seems right. I am waiting for the 12 months to end. PS--I noticed that the slightest skin nick or single hair root pull, causes significant bleeding.

[Nanatotwo]

I am having a molar removed soon and as I’m on Apixaban my dentist wants me to stop 2 days before. Also I have atrial fibrillation so the anaesthetic won’t contain adrenaline. I think the dentist may stitch the wound.

Good luck