My dentist has many patients on warfarin. (Welcome to Florida.) I have an On-X valve, with a target INR range of 1.5-2.5. I had an extraction & implant about 2 years after AVR surgery. I did not change my medication, and I did not have any bleeding issues, even with the extraction. The only thing I would change is request that they do not add the epinephrine to the Novocaine shot. I did not like that one bit. Doc did give me a 10-day antibiotic surrounding the extraction, as well as the standard 2000 mg pre-med for the implant appointments. I am thrilled that the rotten tooth is gone and there is a pretty implant in it's place. I have a feeling that several tooth infections in a row a few years prior to surgery affected the decline rate of my valve.
Side note, I had a breast tissue biopsy that the doctor required me to go off warfarin and bridge with heparin. I did not get the opportunity to speak with the doctor or nurse prior to the procedure, and really wish I had pushed for at least a phone consult. I had an awful time with the heparin shots, and still have marks on my belly 18 months later. I'd like to believe I would have been fine with my lower INR range, but I'm not a doctor.