Sticky Blood-Hughes Syndrome Support
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Tooth Extractions

I I have to have a tooth out probably, as the filling would be way below the gum, and any bleeding

would apparently be difficult to stop. With an extraction the hole can be plugged and pressure

applied. I have not had an extraction before, and am very nervous about it. I would possibly have

gone for a general anaesthetic but my concern is about the known deterioration, cognitive decline

which is well documented after the use of an anaesthetic. My memory, concentration etc. is quite

poor and I dont want to aggravate this any further. I would others opinions on this. Thank you.

15 Replies

The way dentists deal with us now is very different from a few years ago when you came off warfarin in hospital, had the extraction and went back on warfarin and came out the next day. These days many dentists will do an extraction so long as you are not much above 3.0 (assuming you are on warfarin) Some will do them in dentists surgeries, others prefer to refer you to hospital dental services.

The main thing is to make sure the dentist is aware and for them to discuss options with you. An alternative might be to have bridging coagulation with Fragmin injections.

I had no problems having a couple of extractions in a hospital setting with an INR of around 3.1 (my usual is 3.8 to 4.0) back on normal dose the day after.

Best wishes


Thank you Tim47 for your helpful reply. He is now talking of a filling to

start with.


Had an extraction done a couple of years ago. Everything went fine and no bleeding afterwards. Inr had to be below a certain level but can't recall what it was; not too low as I recall as didn't need heparin top up.

Depending on which tooth it is shouldn't take too long for the procedure.

Good luck


Thank you panda60 for your reply.


Hi there - I had a tooth extraction last October on warfarin (my INR was about 2.8) and another extraction a few months ago on rivaroxaban. Both were absolutely fine - no excessive bleeding and the procedure was carried out in the dentists chair, and took about 5 minutes. General anaesthetic honestly isn't necessary at all - the risks would far far outweigh the benefits. Local anaesthetic is injected and all you will feel is pressure being applied - it doesn't hurt. If the tooth extraction is simple and quick then you probably won't have much pain afterwards either. The longer and more difficult the procedure, then you might need some paracetamol afterwards for a day or so. You will be absolutely fine - I promise!


Thank you merrohawk for your helpful reply.


Have to agree with merrohawk- I had a tooth out and stopped Rivaroxaban 12 hours before and restart 6 hours after. The dentist actually sutured the gum to give a better healing and Bleeding was oozing a hour or two more than normal. Healed up really well.


Many thanks ozchick.


I had my wisdom tooth out I was scared but all when the well just had my INR looked at that morning to see if it was ok and it was all when the well so good look let us know how you gone x


Thank you Lesley61,


I had a tooth extracted last year under general anesthesia. Everything went fine and I was "under" for less than 10 minutes. In fact, when I came to, I was not even aware that the extraction was already done. I was talking when the anesthesia took effect and when I came to I finished my sentence and was a little confused that the dentist all hygienist had been on one side of the room and now was on the other.

I had bridged off of warfarin before the procedure. The oral surgeon who is not familiar with APS was skeptical of my assurances that I probably would not bleed anymore than any other patient. Without knowing the cost, I filled a prescription for a topical mouthwash that would curtail bleeding. I received two roughly 15 ounce bottles which I found out later cost my insurance company $1500. Of those two bottles I used one application which came to about 1 ounce. Had I known the cost of that drug I never would've filled the prescription.

Good luck. I hope your experience will be as boringly normal as mine.


Hello GinaD for your info. I guess you are in America. Yes I am on Warfarin

3-4. The Dentist wants the INR at3.00.


Are the teeth on top or bottom? I had two upper teeth extracted this past summer. Where the teeth are located determined my protocol. They used only novocaine and I continued my normal course of Coumadin. Had they been on the bottom, I would have had to go off Coumadin, switch to Lovenox, hold all meds, etc.


Thank you Holley for your info.


I am planning to pull out my partially erupted wisdom tooth. I am very nervous :( I really don’t want to !

The orthodontists are always seen as ghosts in my nightmares. But I can’t really help my very awful headache. Hence I have fixed an appointment with my dentist at Clearbrook, Oshawa . Can you please share your experience when you had wisdom tooth extraction? Was that very painful? Am I supposed to not have anything hard ? If so, for how long should I avoid such food? Please help!


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