ET and dental treatment

[SazzaC]

Hi all

Am due to have a tooth out, am seeing consultant in 10 days....my dentist refused to do treatment as on aspirin and hydroxycarmabide. Has anyone else had an extraction and if so did you stop taking aspirin beforehand. Many thanks..

[Cja1956]

I’m also on hydroxyurea and aspirin. I’m supposed to have two extractions next week but my hemoglobin went from 11.2 to 9.5 in the last month so now I am thinking about not having it done yet. He did have me give a form to my hematologist to sign that it was OK to do. But that was before my hemoglobin dropped. I’m going to talk to her again on Monday to see if it’s OK to do.

[hunter5582]

Yes to stopping aspirin before an extraction. Three days is usually enough based on recent recommendations I have received. The hydroxycarbamide should not make any difference. It is not an anticoagulant. It is more important for providers to avoid exposure to your blood, but they need to do that anyway. It should not make any difference.

This sounds like some ignorance about MPNs affecting the dentist's judgement. Perhaps if you have your hematologist do a consult it would solve the problem.

[SazzaC in reply to hunter5582]

👍

[OZland in reply to hunter5582]

I went to dental surgeon who personally called my haemothology to double check and they confirmed that it is no problems. But yes to no aspirin for couple of days before procedure

[Scottishterrier]

no I am on a blood thinner called dypridamole which prescribed by hospital I attend the dental unit at the hospital I attend for my et jak2+ and have had a few teeth taking out but never had to stop my blood thinners

Stay safe

Scottish terrier xx

[SazzaC in reply to Scottishterrier]

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[Scottishterrier]

why not get your consultant to write a letter to give to your dentist about your condition and if there is any risk to get your tooth or as your consultant advice should you stop your aspirin if they see no problems ask for a letter stating that you asked your consultant and he has no problems with getting your tooth out whilst taking aspirin and dentist should go ahead with tooth extraction

Stay safe

Scottish terrier xx

[Leepee]

Hi I have ET on only asprin have had 2 teeth out since my diagnosis the first was not good not because of bleeding but was bad extraction ended up dry socket then burning mouth syndrome waited 2 year to have the next one out but had a really great dentsist and was perfect no bleeding no pain 🙂 so pays to have a good dentist

[SazzaC in reply to Leepee]

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[LaalRobbo]

Hi, i'm just on Aspirin and didn't stop taking when I had a tooth out a couple of months ago and all was fine with no problems at all.

[SazzaC in reply to LaalRobbo]

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[AngiP in reply to SazzaC]

Hi, I'm on Aspirin and Hyroxy had a tooth extracted last week, didn't stop taking either, everything was fine no problems at all

[SazzaC in reply to AngiP]

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[Wyebird]

hi I had major dental work done. 11/2hrs trying to remove an implant!!! I think I stopped clopidogrel for a few days. Just ask your consultant or nurse to write a letter/ email. Good luck x

[Rem31]

I think it’s possible your initial consultant (hospital?) appointment will be a consultation and you’ll have the opportunity to ask about stopping the aspirin before the actual extraction appointment. In the meantime it would be best to ask your haematologist for their advice too.

I’m due to have an extraction at a hospital dental clinic as my dentist wouldn’t do it due to my ET and another medical condition. My first hospital dental appointment was a consultation, to discuss what to expect and then set a date for the extraction.

At the consultation I was told it’s not now current (uk) practice to stop the aspirin before an extraction.. not sure my haematology team would agree as their general advice is to stop 5-7 days ahead of an invasive procedure.

Nine years ago I had an extraction having stopped the aspirin 3 days before and all was fine.

That’s just my experience so far.

[Mcrg]

hi, i was referred to the local hospital dental unit ( i am in England)for mine. Bloods to check platelets level beforehand and they consultatedbthe haematologist also. Good luck.

[Mcrg]

sorry, just reread and apologies for the spelling. I forgot to say that I had a tooth out in 2018, not long after diagnosis and on aspirin 75mg daily. I bled for twelve hours and ended up having stiches in the gum. Was clotting but not stipping and was horrible, so speak to haematology about stopping the aspirin first that's why I was referred to the hospital this time

[azaelea]

Hi, I too was on aspirin and Hydroxycarbamide and had a back tooth out with no bother. I asked Dentist about stopping aspirin before extraction but he said no need. Didn’t have excess bleeding.

[ainslie]

I had extraction and implant in with PV and 75mg aspirin, dentist was fine with it, no probs

[Hopetohelp]

I have et and took my elderly Mum, 91, who hasn’t got et but is on 75mg aspirin daily, to the dentist where he took the tooth out there and then. I mentioned the aspirin as I was worried about bleeding and he said not to worry as they have something that will stop the bleeding if necessary should there be a problem

[Mpn1967]

My doctors always keep the Asprin as it is.. good luck. I have to go the oral surgeon in October. No problem.

[Pkm52]

I have Jak2+ ET and am on Hydroxycarbamide 800mg and take Aspirin 500mg. daily. Hunter5582's comments were spot on. I had a lesion removed that was next to my eye and a molar extracted this year. I stopped the Aspirin for 2 days before the eye surgery but not for my tooth extraction. I had no problems. I make it quite clear to my clinicians that I would rather bleed than throw a clot. I am actually married to a dentist and he said he's never seen a problem (40 years plus). Bleeding is a nuisance when it obstructs your visual field. I am a Nurse Practitioner in the US (40 years plus) and haven't managed a case of problematic peri or post surgical bleeding secondary to Aspirin being on board. It sounds like you sounded "scary" to the dentist. Is he inexperienced? A single blood draw to document the time you take to clot should make everyone calm down. Good luck.

[Jamesxyz]

Hi,

I'm on aspirin and Hydrea and had tooth extraction. I didn't stop either.

Oral surgeon was not concerned. Get a letter from your hematologist or go to another dentist.

[Janis12]

Hi, I had an extraction last year with no problems at all. I take Clopidogrel (blood thinner) and hydroxycarbamide. After discussing my condition with the Dentist, we decided it would be best for her to contact my haematologist. The outcome was to continue with my blood thinner and hydroxy and a normal extraction was carried out, 'bish bash, bosh'!! Good luck.

[3195]

I had 2 dentists refuse to treat me, just based on my ET diagnosis. The 3rd one I met with requested a letter from my Oncologist. My Oncologist wrote the letter, but also spoke with him on the phone.

[hunter5582 in reply to 3195]

What incredible ignorance. You are better off not being treated by dentists who discriminate against people because of their medical conditions. I am reasonably certain it is a violation of the ethical code for dentists. I expect it is also a violation of the ADA. If a dentist has questions about dental treatment in the context of a co-occurring medical condition then the proper thing to do is to consult with the patient's physician. I would consider refusing services to someone with ET to be an actionable violation of professional standards.

Note that I have NEVER had a dentist refuse services in 30 years of living with a MPN. Hope the new dentist, who followed the proper protocol, works out well.

[SazzaC in reply to hunter5582]

👍

[Atirax]

I had 2 teeth out 3 weeks ago I'm also on Hydra 1500 x 3days 1000 x 4 days asprin every day xx hzd to wait 8 months after heart attack but no other issues at all.

[SazzaC in reply to Atirax]

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[KentBee]

Hi, when I had a tooth out had to stop Aspirin for two days but had to continue with Hydroxycarbamide. I didn’t have any problems, good luck.

[SazzaC in reply to KentBee]

Thank you for replying 👍

[BloodZero]

I stayed on the meds for extraction but will not do so again. Next time im planning to stop aspirin a week beforehand.

I lost a lot of blood. Was in emergency room twice and back in the dentist chair twice.

I was physically sick from swallowing so much blood (they tell you not to spit it out). It was four days of pain, sleeplessness, hunger and anxiety.

[SazzaC]

Thanks for your honest reply....I will obviously discuss with consultant beforehand....Iam concerned as I seriously bleed from just having bloods taken or injections!! I guess everyone is diffferent......will keep you posted 👍

[Serge___]

I had an extraction, and stopped blood thinners a few days before. I said nothing about Hydrea. It went smoothly. PV has no influence on teeth according to my dentist.

[Kraftcheese in reply to Serge___]

It's not the PV that's the problem with tooth extraction, but being on blood thinners can cause bleeding problems in some people.

[LucyAshtonGeering]

Hi! I’ve had a lot of dental work over the past 18 months, and stopped my aspirin for a few days either side of each procedure. Hope yours goes well, please keep us posted.