Coumadin and Dentist appointment

[Igor]

I will be going to a dentist to do just regular cleaning and as result my Coumadin clinic nurse tells me that my preparation to this even will be as follows:
A. not taking Coumadin for 3 days prior to the appointment day
B. To take 4 antibiotics an hour before my appointment
C. continue taking Coumadin on the day of dentist appointment

My only concern here, does it really needed to get off Coumadin for 3 DAYS. It seems a little big for just regular cleaning

I?m sure a lot of you already went through this and just wondering if all of you were taken off Coumadin for 3 days

 

[Johnny Stephens]

Wha?

Wha?

Hi Igor

Granted, I've not yet had any dental work since my surgery, but I did discuss with my cardiologist what to do before even a simple cleaning. Prophylactic antibiotics (2gm Amoxycillin 1 hr before procedure) was all that was mentioned. Nothing was said about having to go off Coumadin.

I would also like to hear the others' experience with this.

 

[Ross]

I discusssed this with my dentist and he said that it's not necessary for routine cleanings and the like. The only time he would have me taken off is if I needed oral surgery. Wisdom teeth pulled or something of that nature. Outside of that, 4-500mg Amoxicillin capsules 1 hour before the appointment.

An added note-I was at an INR of 2.5 when I had my teeth cleaned and bleeding was not a problem at all.

 

[Mb]

Hi!

Just thought I would add - antibiotics YES, off coumaden NO for a simple cleaning.

And, my husband was told this by three doctors.

Marybeth



Best wishes!

 

[Christina]

Hi Igor,

I am almost 2 years post-op and have gone to the dentist several times since my surgery. There is no reason to go off the Coumadin for a simple dental cleaning, and I have not done so. My doctor advised me to take 4x500mg antibiotics an hour before the appointment and that's what I have done without any problems.
Dental surgery is different. You will be off Coumadin 3 days prior.
Your nurse is wrong!

Christina
AVR's 8/7/00 & 8/18/00
Aortic Stenosis
TMC, Tucson. AZ.
Dr. Gulshan Sethi

 

[Lorraine]

Hi Igor,

Funny you should post this thread. I'm going to the dentist tomorrow for a routine cleaning.
This will be my third cleaning since surgery. My cardio told me absolutely not to go off Coumadin for a routine cleaning. Just take the antibiotics an hour before your appointment.
I agree with the others. You only need to go off the Coumadin if you have Dental surgery or any other type of major surgery. Not for a routine cleaning! Your nurse is wrong! Take care and God Bless.

 

[Blanche]

Igor:
My advise to anyone on coumadin is NEVER, NEVER, NEVER stop your medication unless specifically directed by your cardiologist AND question the cardiologist about the reasons for discontinuation and about what other measures should be taken to safegard you while off Coumadin.

My husband has been on coumadin since October 1990. In that time, he has had many crowns, a root canal, numerous teeth cleanings, and an extraction...and never has his coumadin been discontinued. I nearly go into a rage when I hear dentists or hygenists tell patients that they must go off coumadin. In April this year, a hygenist told my husband that she would not clean his teeth unless he stopped his medication for two days. And, she said that this was policy of the American Dental Association. SHE IS WRONG. I took her a paper from the "resident" expert on coumadin on this board, Al Lodwick. In part it read:

"The January 2000 edition of the Journal of the American Dental Association published a study of 950 people who had 2,400 dental procedures done. NONE of these people stopped their warfarin. There were only 12 incidents (about 1% of the time) where anything more than holding a pad with slight pressure was required to stop bleeding. In these 12 incidents, only 3 times was the INR at or below the therapeutic level. The author also studied 526 people who stopped their warfarin for 575 dental procedures. There were 5 serious complications (about 1% of the time. HOWEVER 4 OF THESE 5 PATIENTS DIED."

Among the conclusions of the study were:
...Serious complications, including death, were 3 times more likely
to occurr if warfarin was stopped then if it was continued."

The article quoted is: Wahl, MJ. Myths of Dental Surgery in Patients Receiving Anticoagulant Therapy. Journal of the American Dental Association, January 2000, p. 77-81.

Igor, I would suggest that you go to Al Lodwick's site, warfarinfo.com, and make copies of the section on "Dental Procedures While on Warfarin" and the information on warfarin and dental procedures found in the Frequently Asked Questions section for your dentist and hygenist.

Hope you find this helpful.

 

[Lynne S]

The first dentist I asked said I would have to go off coumadin for a couple of days before a cleaning. That really scared me. After asking the cardiologist and getting info. from this website I figured the dentist was not familiar with patients on blood thinners. I found a new dentist. I've had several cleanings & do not go off coumadin - just take the antibiotics.

Haven't had any problems.

 

[Nancy]

Joe never goes off Coumadin for dental work. He takes his antibiotics 1 hour before. He's been on Coumadin for 25 years.

 

[Guest]

You guys are going to put me out of business -- you know so much.

 

[Zipper]

Hey Al,

We'll still need you!!! Your guidance has helped us all learn..your book and website are so valuable for all of us. We still have questions that only you have the expertise to answer, and I'm sure that's true of all your patients!!!

You're not going to get off that easy..!!! LOL! You're great!

Zipper *~*

 

[bevbodene]

I have been on Coumadin for 6 years, and my doctor would have a stroke if I went off the Coumadin for a routine cleaning! I, too, stay on it and take 4 of the 500mg antibiotics one hour before my appointment.

I will be having a mole removed from my back in a couple of weeks. When I went to see the dermatologist about it, he told me to get off the Coumadin for 3 days prior to the surgery. I told him that my PCP would absolutely not let me off the Coumadin. When I told my PCP about it, he about flipped! A lot of doctors don't really understand about us heart patients, so we really have to watch out for ourselves. Being aware is the key, and standing up for yourself is a necessity. More often than not, WE know what we're supposed to do and we must speak out.

 

[Guest]

Bev,

You are absolutely right. All the doctor who will be removing the mole needs to do is to document in your records that you have a heat valve and refuse to stop the warfarin, that you have discussed the possibility of excess bleeding and that is still your wishes. You may be asked to sign the document. I have worked on a number of malpractice cases and I guarantee you that this will make it extremely hard for that doctor to be held liable should you have more bleeding than usual and your surgery is not more complicated than expected.

Liability is really the issue, not your health.

 

[Perrster]

Don't sweat it

Don't sweat it

Igor,

I came here some time ago with the exact same concerns as you have expressed. Allodwick (and many others) set me straight.

Antibiotics ONLY for cleanings. Don't mess with your Coumadin. I've since had two cleanings and a root canal...same preparation. If your dentist still insists, get a new one...there's enough of them to go around.

BTW, the antibiotics will change your INR some, so don't test too close after the dental work.

Regards,

 

[cookie]

mouth?

mouth?

Whoa! Just thinking of going off the coumadin make me really nervous. I have many cleanings since my valve replacement and have enver been told to go off the coumadin. Anitbiotics only.
I do have another question maybe someone has experienced. My INR has been staying between 3.0 - 3.5 for the last couple of months now. My question is, I've been getting little blood blisters in my mouth. Not a lot. Maybe one every other week or so. The other day I burnt my mouth on some hot soup and later had some very crusty bread for dinner and where I burned the roof of my mouth it started to bleed. Would not stop! Very small spot. I ended up rinsing my mouth with salt water and applying pressure with a cotton ball soaked in salt water. This worked but have never had my mouth so sensitive before. Any opinions on this? I looked like Dracula for a while! LOL

 

[Granbonny]

Little blood in mouth every morning for last few weeks

Little blood in mouth every morning for last few weeks

Cookie..A few weeks back I noticed a little blood on tissue early in a.m. after getting up but nothing during day. had it checked out in E.R. Nothing..Cardiologist told me last week he was not worried and had 2 week checkup with ENT Dr. today..after having him check it out two weeks ago. he found nothing...Now I think my gums bleed during night..didn't have a chance for a cleaning because my surgery came real fast. ...ENT Dr. thinks it may be coumadin . but I may still check it out with Gastro Dr. in a few weeks if it keeps up because I have had a time with burping. It is scary to see that blood on tissue..but goes away after I rinse once. Bonnie

 

[McCln]

granbonny

granbonny

Please get the bleeding gums checked better. You are not supposed to have bleeding gums. Sounds like you need to change doctor if he says there is nothing to worry about bleeding gums while brushing teeth. Take care and be careful in the heat.

Caroline
09-13-01
Aortic valve replacement
St. Jude's valve