Dental Extraction with INR at 1.9

[ajay_22_86]

I'm fairly certain that it's okay to have an extraction with my INR at 1.9. However, does anyone know of any research that contradicts this? My desired INR range is 2-3. I'm going to contact my hospital tomorrow morning, but this is just in case I can't get through (as my extraction is on Saturday morning!)

 

[halleyg]

I'm fairly certain that it's okay to have an extraction with my INR at 1.9. However, does anyone know of any research that contradicts this? My desired INR range is 2-3. I'm going to contact my hospital tomorrow morning, but this is just in case I can't get through (as my extraction is on Saturday morning!)

I know Woodbutcher had a tooth extracted without lowering his INR at all; I'm pretty sure others have as well. Think it's more of an issue if your dentist will do it or not, some will some won't.

 

[Bina]

If I was going to get a tooth pulled I would do it with an INR of 2.0 or 2.5, not much difference, but I don't know what my dentist would prefer. It hasn't happened yet. After the tooth pulling it's important to follow instructions: rest, don't drink from straws, etc.

 

[dick0236]

Over the years, I have had a few extractions, root canals, crowns, periodontal treatements etc. and have never had a dentist or oral surgeon ask about INR levels. I would not worry about a 1.9.

 

[ajay_22_86]

Thanks for the advice Bina

Halleyg - I didn't lower my INR intentionally, it just naturally went like that. I guess I was wondering if there were any known draw backs for heart patients having a tooth extracted when the INR is slightly below range. Like the risk of bleeding more when we're above range. The only thing I can think of is that the antibiotics I take prior to the oral surgery will interact with the warfarin in my system and cause my INR to go even lower...which would be a risk! :O

 

[Bina]

Last month at my dental appt my INR actually went up a bit from taking the single large dose of antibs.

 

[halleyg]

Thanks for the advice Bina

Halleyg - I didn't lower my INR intentionally, it just naturally went like that. I guess I was wondering if there were any known draw backs for heart patients having a tooth extracted when the INR is slightly below range. Like the risk of bleeding more when we're above range. The only thing I can think of is that the antibiotics I take prior to the oral surgery will interact with the warfarin in my system and cause my INR to go even lower...which would be a risk! :O

Ohhh, got it! Can understand your concern. :smile2:

 

[Protimenow]

If you have a meter and do self-testing, you can probably do a test just before you go to the dentist. Of course, you probably won't cancel regardless of INR (unless it's extremely high or extremely low), but it would be good to inform your dentist before she (or he?) starts work on your teeth.

For extractions, you'll probably bleed more and it'll take longer for the hole to clot, but so far I haven't seen any reports of people bleeding to death from extractions (yes, I'm being a bit sarcastic). I had an extraction a few years ago and didn't know my INR at the time, but with enough gauze pads to pack the hole, it did, eventually, stop bleeding.

With a 1.9, I don't know that I'd be too worried about excessive clotting.

 

[sue943]

I had a wisdom tooth out earlier this year with an INR of about 3.3, I didn't bleed at all. the dental surgeon put a stitch over the socket and it was fine. I took three grams of antibiotic an hour before.

 

[ajay_22_86]

Thanks for the info guys

 

[olefin]

Our local oral surgeon and some dentist refuse to do extractions while on warfarin unless the patients cardiologist or doctor says otherwise. My cardiologist instructed me to never stop warfarin for extractions or other gum surgery. He also said to lower INR before the extraction but not go lower than 2.0. My control is 2.5 to 3.5.

I had gum surgery (3 stitches) while INR was 2.3. The Endodontics said there was no more blood than someone not on warfarin.


Below is copied from here.
Practitioners should consult with the patient’s physician if necessary to determine his or her most recent INR before dental surgery is performed; the INR should not exceed 4.0 or the PTR 2.2. If the patient’s anticoagulation level exceeds the therapeutic range, the physician may recommend withdrawing the anticoagulant therapy or reducing the dosage until the level is within the therapeutic range so that dental surgery can proceed safely.