Tooth Extraction and coumadin

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Missy

VR.org Supporter
Supporting Member
Joined
Jun 12, 2001
Messages
448
Location
New Mexico
I have a loose tooth. No saving it.

I did a search for stopping coumadin for the procedure. I really don't have lots of time and need to know how to talk to the dentist and local dr.

Do I or do I not stay on coumadin??? Help!!!!


Last time I had a tooth pulled I stopped the coumadin and went to the hospital twice a day for shots. I no longer have that kind of insurance. Even the co pay on that is expensive but I would rather not have to do that.


My bridge hooks onto it. So don't know what the dentist intends to do about that! Any suggestions?
 
Missy said:
I have a loose tooth. No saving it.

I did a search for stopping coumadin for the procedure. I really don't have lots of time and need to know how to talk to the dentist and local dr.

Do I or do I not stay on coumadin??? Help!!!!


Last time I had a tooth pulled I stopped the coumadin and went to the hospital twice a day for shots. I no longer have that kind of insurance. Even the co pay on that is expensive but I would rather not have to do that.


My bridge hooks onto it. So don't know what the dentist intends to do about that! Any suggestions?
Click to expand...

Hey Missy!
Don't sweat it! I have had two molars extracted & both times I did not have to come off the coumadin. The bleeding took a little longer to coagulate but it was no biggy so don't fret.

You do have to get on antibiotics though prior to having the procedure done for sure!

Good luck & you should be fine! :)

I'm not sure about the bridge however, but I'm sure the dentist will figure that one out. I have a bridge too, but luckily the molar they removed was not connected to it.
 
njean said:
Hey Missy!
Don't sweat it! I have had two molars extracted & both times I did not have to come off the coumadin. The bleeding took a little longer to coagulate but it was no biggy so don't fret.

You do have to get on antibiotics though prior to having the procedure done for sure!

Good luck & you should be fine! :)

I'm not sure about the bridge however, but I'm sure the dentist will figure that one out. I have a bridge too, but luckily the molar they removed was not connected to it.
Click to expand...

One very important thing I forgot Missy, is that the dentist & your cardio will most likely want you to be in therapuetic (?) range, say 2.0 - 2.5 before doing the extraction. I am sure that if you were having more than one extraction or if there is a possibility of more than one extraction, then the dentist will want you off a day or so prior to the procedure & then bridge with Lovenox until you're in therapuetic range.

I hope others come in & offer their advice on this too.

You may want to check out Al Lodwick page:

http://www.warfarinfo.com/dental-procedures.htm
 
Missy said:
I have a loose tooth. No saving it.

I did a search for stopping coumadin for the procedure. I really don't have lots of time and need to know how to talk to the dentist and local dr.

Do I or do I not stay on coumadin??? Help!!!!


Last time I had a tooth pulled I stopped the coumadin and went to the hospital twice a day for shots. I no longer have that kind of insurance. Even the co pay on that is expensive but I would rather not have to do that.


My bridge hooks onto it. So don't know what the dentist intends to do about that! Any suggestions?
Click to expand...

Missy-I have not always lived in New Mexico, and had to find an oral surgeon just a couple of years ago. When I needed a wisdom tooth extracted I already knew (from my own research) that "up to date" oral surgeons no longer required patients to go off warfarin (Coumadin). However, I had to make a lot of calls to find an oral surgeon who wasn't stuck in the past. My Dad, though not a dentist, was a professor in the University of Minnesota school of dentistry. (I mention this because I have always had good access to top notch dentists, and feel I have a better chance of knowing quality when I see it, as a result of being around so many people in the dental field for a long time).

I have found a person I think is a great oral surgeon in Albuquerque, and I would be happy give you his name, number etc. if you want.

One other thing--please don't even think of having this done by anyone other than an oral surgeon. The risk of excessive bleeding can be greatly reduced depending on the skill and training of the Dr. who does the extraction.
 
Missy, I've had both a tooth extraction and other dental work and oral surgery that involved removing an overgrowth jawbone and never came off coumadin. I did make sure I was in range though. I had no problems. My oral surgeon said there would not be any bleeding he would encounter that he wasn't equipped to handle. When I go on Lovenox I seem to be much more at risk of extensive bleeding. Ross had major problems with bleeding following dental work and going on Lovenox. You might want to run a search here on VR.
 
I was fully coagulated (and antibioticized!) when I had a molar extracted last year with absolutely no difficulties. My dentist that I have been going to for about 16 years did the procedure. He just pulled it out, inserted some kind of thin layer to help control the bleeding and stitched it up.
 
My dentist didn't believe me when I told him that I do not have to reduce my INR (2.5-3.5). He said he has a lot of experience and knows what he is doing.He was arrogant. He said he would not extract my tooth unless the INR was no greater than 2.0.
 
What about crowns?

What about crowns?

I would add to the question about extractions, a question about crowns. Should I see an oral surgeon for a crown?

Thanks,
Maryka
------
BVR/Aortic root replacement Dec. 23, 2008, Johns Hopkins, Dr. Duke Cameron
 
Kinda like driving in a thumb tack with a sledge hammer

Kinda like driving in a thumb tack with a sledge hammer

Maryka:

Al and I have had tons of dental work done without stopping anticoagulation. Al has about 12 crowns and I have 28 crowns...all done by our regular dentist....over a 30 year period. The oral surgeons that Al and our son used did not do crown work. Actually, the crowns we have did not involve surgery. In November I had a root canal, while fully anticoagulated, without surgery.

Blanche
 
So far I have not been taken off Coumadin for any of my dental work. I have had two crowns put in with the last year and half. No problems at all. All I make sure is that I take my antibiotics. Glad for the info about the root canal though. Good to know I don't have to go off Coumadin, I ever need a crown.
 
Herb M said:
My dentist didn't believe me when I told him that I do not have to reduce my INR (2.5-3.5). He said he has a lot of experience and knows what he is doing.He was arrogant. He said he would not extract my tooth unless the INR was no greater than 2.0.
Click to expand...

So he'd rather risk you having a stroke then deal with bleeding. The guy needs to get with the program. Copy this and have him read it:
http://www.valvereplacement.com/forums/attachment.php?attachmentid=6310&d=1223065492
 
Hi eveyone,

What are the dental standards, for antibiotics? I go to a general dentist,(have a pig valve). I had some inflamation in the gum area. The next day I called my general doctor on call ( it was a Saturday) He prescribed Ampicillin 500mg three times a day for 7 days. That Monday I went to my dentist. Well to make a long story short, he had to pull the tooth,and is making a bridge. In the meantime I finished the ampicillin. Was off a day and a half, then 1hr before my tooth extraction, took 4 500mg of amoxicillin . Then for the next week, he had me take 500mg of amoxicillin three times a day. (whew!) I am now on the last day for this, then I will be finished. When I go back to the dentist in 2 wks. I take another 4 500mg of amoxicillin 1hr before procedure. After that, again, I take one 500mg, three times a day until the pills are gone. I think there will be 15 pills. What do you think about that? Does that sound right?

This is terrible! I don't want to have a MAJOR PANIC ATTACK every time I go to the dentist.
 
Kathy McCain said:
Hi eveyone,

What are the dental standards, for antibiotics? I go to a general dentist,(have a pig valve). I had some inflamation in the gum area. The next day I called my general doctor on call ( it was a Saturday) He prescribed Ampicillin 500mg three times a day for 7 days. That Monday I went to my dentist. Well to make a long story short, he had to pull the tooth,and is making a bridge. In the meantime I finished the ampicillin. Was off a day and a half, then 1hr before my tooth extraction, took 4 500mg of amoxicillin . Then for the next week, he had me take 500mg of amoxicillin three times a day. (whew!) I am now on the last day for this, then I will be finished. When I go back to the dentist in 2 wks. I take another 4 500mg of amoxicillin 1hr before procedure. After that, again, I take one 500mg, three times a day until the pills are gone. I think there will be 15 pills. What do you think about that? Does that sound right?

This is terrible! I don't want to have a MAJOR PANIC ATTACK every time I go to the dentist.
Click to expand...

I understand the firsst 7 days since you had inflamation, but not sure why you are taking anitbiotics after the visit unless they think the infection is still there. Justin takes a large amount 1 hour before the visit, that's it. Here are the dosage guidelines http://www.americanheart.org/presenter.jhtml?identifier=11086 the chart is at the bottom I can't copy it
 
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