Tooth extraction - help please.

[geebee]

I have to have a tooth extracted on November 8th and this is the first one on coumadin. Of course, I will not be coming off coumadin but I will be dropping to the lower end of my range to try and help a little with bleeding.

Antibiotics are already on hand.

I am looking for those who have had a tooth extracted while on coumadin. How bad was the bleeding (according to your dentist as well)? Did you have any problems with bleeding hours later or once it stopped, did the bleeding stay stopped?

This is a molar and the dentist will have to cut it in half to extract. We are doing it on a local and I am praying it doesn't flake as he tries to remove it as that will require much more time. I am a very bad dental patient and am stressing a little bit here.

Thanks for listening.

 

[ALCapshaw2]

Doesn't sound like fun to me.

Obvious question:

How many extractiions has your dentist performed on Coumadin patients?

You may want to consult with an Oral Surgeon while you still have time. I would think he would be better prepared to handle any 'difficulties' that may arise. And be sure to ask about staying on your anticoagulation (at reduced INR).

'AL Capshaw'

 

[Ross]

Don't stress, it's not going to be a big deal. On molars, they have a tool to split the tooth in half and then remove each half. They'll sew the socket shut or use some of the fancy new stuff to cause you to clot on the socket. Bleeding isn't really a big thing. Just like everything else, you'll bleed a little longer, but it should stop fairly easily.

 

[bvdr]

Hi Gina, A couple of weeks ago I had a crown on a molar become loose. Xray showed a possible fracture so I was referred to a Prostadontist (sp?). He worked and worked to get the crown off and the tooth broke off at the gum line. Monday I had dental impressions made for a partial and next Tuesday the tooth gets extracted. It is the first one for me too since starting coumadin. I'm not coming off of it either. It will be interesting to see how it works out. I'm not on antibiotics now but will pre-medicate for the extraction. Are you taking into account that your INR might climb a bit (or a whole lot) from the antibiotics? I've had my heart start racing from novacaine a couple of times in the past but that hasn't happened since I've been on the Flecainide.

I don't know how he will get the tooth out but he said to let him worry about it. He used some king of band tightened around the crown to try to remove it and it slipped and cut his finger right through the glove. I'll have to bleed quite a bit to beat that. I think he should have had a couple of sutures. It was a bit awkward for him to have a pressure dressing on a finger and then 2 gloves on that hand and still work on a tooth.

I'll be glad when it is all done won't you?

 

[geebee]

Thanks for the support.

Betty - I sure do wish this was over. This tooth had a root canal and a crown and I thought all was well. However, the crown popped off and the dentist found decay on the surface of the tooth. I am really disappointed as I am trying so hard to keep my teeth and I thought a rool canal and crown would be sufficient forever.

Oh well - another surprise. Now I can't help but worry about all the other teeth with similar work.

Sorry to whine - this too shall pass.

 

[LUVMyBirman]

Hi Gina,

Had all of my wisdoms pulled 7 years ago. Within 6 months of surgery. Was always told to leave them in as they were not impacted. Changed dentists do to relocation and...hello! Those babies need to come out. Actual extractions were not a big deal. He knocked me out good! My major concern was being off the Coumadin and using Lovenox.

One issue I had was bleeding as my levels started to come up. Day 3-4. Went back in for some packing.

I also had another molar removed do to a failed root canal last year. Lovenox again. Have not been sucessful in finding someone that will touch me on Coumadin. This last molar...oral surgeon was a panic case. He sent me for an IV antibotic...also insisted on taking my pre-meds. For one little tooth! Had the other three just on the pre-meds.

Rinsing with warm salt water (no swishing). Helps with hygine during the healing process. Also used Peroxyl rinse.

You will be fine! Sounds like a bigger deal than it really is! Actually the big deal is the circus some of these professionals turn on a Coumadin case. I don't think you can bleed to death out of a tiny socket in your gum!

 

[Dennis S]

I will be anxious to hear how this works out.

I will be anxious to hear how this works out.

I could probably use an extraction & dental implant myself. Gina, I sure don't know your situation, but there can be a tremendous between a dentist & an oral surgeon. I am sure you know best for your own situation. But--I have done it both ways, and would only use an oral surgeon from now own. This was before coumadin, and I found the extraction by the dentist resulted in a lot more bleeding than the one done by the oral surgeon.

 

[aussigal]

Gina...just a thought...if are are a really nervous dental patient like me I would be begging for IV sedation instead of a local...
I wish you good luck with the procedure...

 

[Wise]

While I can't be of any help, I want to extend wishes for an eventless extraction. Take care.

 

[imhayley]

I will call the tooth fairy!

I will call the tooth fairy!

HI Gina and sorry to hear about the loss of a tooth I hate going to the dentist too and want you to know that If I could be there to hold your hand I would!! Best of luck.

 

[geebee]

Gina...just a thought...if are are a really nervous dental patient like me I would be begging for IV sedation instead of a local...
I wish you good luck with the procedure...

I would love sedation but, with chronic a-fib, my cardio is against it. If I could get my insurance to pay for a hospital stay with monitoring, that might be different but - not going to happen.

 

[Dennis S]

Question

Question

Are you planning on using an oral surgeon,or a regular dentist?

 

[temp69]

GB: Hope all goes well for you, I'll be thinking about you. I really believe it's not that big of a deal, that you'll be just fine, so try your best not to worry. Remember that all the worrying we do won't move a single grain of sand.

All my best to you.

 

[Andrea12]

tooth extraction

tooth extraction

I had a tooth abcsess 2 wks after my open heart surgery to replace 2 valves and my aortic root. I went right back into the hospital, started getting pumped with antibiotics and came off my coumadin (switched to Lovenox), when my INR levels came down, they pulled the tooth. Luckily, all my blood cultures came back negative, Thank God. within an hour of the tooth being gone, I got a dose of Coumadin and the injectible Lovenox so I guess you don't have to worry about the wound from the tooth bleeding once it clots up.

 

[geebee]

Are you planning on using an oral surgeon,or a regular dentist?

I am not using an oral surgeon but my dentist is an implant specialist and I feel very confident with him. The tooth is not impacted and should not be an issue coming out (knock on wood).

The one great thing about him is the fact that he doesn't freak out about me being on coumadin. That seems to be rare these days.

 

[Lynlw]

Can you use nitrous? it's still hurts alittle when you are having work done, but you don't really care, lyn

 

[Nan]

Hi Gina, I haven't had any experience of an extraction while on Coumadin, but just wanted to send you my best wishes for an effortless extraction with little bleeding! Sounds like there is stuff they can use to help you clot right away.

Don't stress too much, it'l be over soon and easier than you think.

 

[geebee]

Can you use nitrous? it's still hurts alittle when you are having work done, but you don't really care, lyn

Nope - doesn't fit well with my a-fib. Not sure if that is a usual reaction but, then, I am far from usual.

 

[Dennis S]

Dentist:

Dentist:

There is a lot to be said for having someone who is familiar with your mouth. After my regular dentist "extracted" one of my wisdom teeth he advised me that (in my particular case) I should only use an oral surgeon in the future for extractions. If your dentist is good at doing implants, he is far beyond most regular dentists.

We will all be anxious to learn that everything is fine. I am not far behind you. I had all my dental work double checked just before surgery, and there was one problem tooth. The Endodontist thought he got everything, but did say it was difficult & he couldn't make any promises. I guess it was a good thing he didn't promise, because it looks like it isn't going to make it.

 

[geebee]

I will definitely let everyone know how things go. I just wish it were tomorrow so I could get this over with. I am an old pro at root canals but this has got me bummed since losing my teeth has always been a fear (and one of my recurring nightmares).

I figure if my dentist can do surgical implants, he can handle a tooth extraction. I am also sure I won't bleed to death from it as I don't think there are any arteries under the tooth. I am worried about infection but that is why we have the antibiotics so, fingers and toes are crossed.

Thanks everyone - you are great.