Dental work and warfarin ....how do you manage?

[tassie]

For those on warfarin, how does it impact your dental appointments?

Do you have to stop the warfarin to have regular checks or just for major work? What extra precautions if any do you have to take?

[Sarita]

Havent had to go to the dentist yet since taking warfarin. The important thing is to make sure you tell the dentist so they can take the necessary precautions.

[lucky1]

for normal work I make no change to my dosage

I have had a tooth pulled, all I did was to reduce my warfarin dose by half for 3 days leading into the procedure. That was my control and the docs were aware of what I had done.

lucky1

[jetjetjet]

i had to set it up between, my oral surgen and my doc - i had to be at 2.2 two days before test and, morning of test. but my surgen knew nothing of aps i actually spoke to him for a half hour after pre-appointment , discussion on just what it was , he was great ,and a good listener [ more dc s should be as attentive] all went welll -----------jet ps he actually let me and my dc handle it, which is unusual .

[taffydaffy]

Hi All

Last year my warfarin was 4 and my guide is 3.5 - 4 my dentist took 5 of my teeth out that day if your blood is to thin he won't touch you I miss my perfect front teeth I have Sjogren's Syndrome and it caused gum disease and my lovely white teeth had to go I soooo miss them x

[Jade]

My dentist knows I have warfarin. She does all the normal work cleaning filling etc with nothing changing I have never so much as had a bruise on my face from an injection. She has also taken teeth out with no problems. She put a clotting agent in the socket after the extraction and it has been fine. This is over 7 years now.

[ciaronsmum]

I had a tooth out last week. The dentist just asked me to try and get my INR down to 3.5. It was all OK, he packed the hole and put in a stitch. It seems to be healing.

Louise

[Gadgets]

I told my dentist I am on warfarin with an INR 4 to 5. Not a problem, she is just extra gentle. I guess if I had any big jobs done I would come off warfarin for 24 hrs (no longer)

[sbncmo]

Usually, my dentist would have my husband stop his warfarin for a couple of days prior to tooth extraction & he would stitch up the opening. The last extraction, he didn't do this. My husband didn't start bleeding in the office, so the dentist sent him home, about 5 miles away. By the time he got home at 9:00 a.m., the cotton pads were saturated with blood, his mouth was full of blood, he had swallowed a bunch of blood. I started packing his mouth with more cotton pads every couple of minutes, leaving the original ones in. Then he started throwing up blood from swallowing so much. I had him suck on green tea bags & ice cubes, anything I could think of, the whole time calling the dentist & leaving messages. They finally called me back at 5:00 p.m. & said to bring him back. He was in such bad shape, that they wouldn't let me back with him. He was throwing up more blood & passed out. When they stablized him by stitching it and putting some kind of glue or gel in the opening, he had to be sent across the street to the ER where they said he had lost a considerable amount of blood because his blood pressure would greatly drop from when he was lying down to when he stood up. And then the dentist's office had the nerve to charge us for sanitizing their room! Boy, was I ticked! But the dentist said he will never do that again, that he will always do as he had done before & stop the warfarin before tooth extraction.

I don't know about tooth cleaning. I don't think he has ever needed it because he has never ever had plaque on his teeth. I do know that if you have heart conditions that you need to take antibiotics for a couple of days prior to cleaning - my situation.

I guess the important thing is, talk to your dentist & make sure he/she knows your situation, that he will stitch the wound & pack it.

Shelia

[tim47]

I find that dentists are much more willing to do extractions when the INR is up to 3.0 but then they start getting cautious.We must tell them of course. I have a target of 3.8 to 4.0 and wouldn't be prepared to drop below 3.5-we should not agree to stopping for a few days if we have a high INR. I had to have some extractions prior to a heart job and they were done in a hospital setting, I think the INR was about 3.5 and was checked immediately before the procedure (with an old version Coagucheck)

Years ago, to avoid going in to hospital for several days, as used to happen, I took part in a trial of a new mouthwash that was expected to stop bleeding after an extraction. I was the only person on whom it didn't work, it started bleeding at night and I had to go back in next day. Whilst at reception, the nurse saw the doctor along the corridor and called out to him saying Doctor, its that bleeder from yesterday!" I knew what she meant. ;-0

My dentist also knows I have Sjogrens and takes particular care when I'm in the chair.