Dental Implants and Warfarin Therapy

JLmatus

Active member
I need some advice. My Dentist told me that I need a dental implant. I have an ON-X heart valve and am on warfarin. The Dentist wants me to go off the warfarin 2 to 3 days prior to my dental implant appointments. My Cardiologist says that he will go along with what the Dentist recommends. I am leary about going off the warfarin. Studies that I have read seem to suggest that the risk of a blood clot while off warfarin exceeds the bleeding risk while taking warfarin during dental implant procedures. Has anyone had any expierence with dental implants while on warfarin.
 

tom in MO

Well-known member
I don't know anything specific about implants, but I went off warfarin for a surgical procedure w/o bridging. It went fine. I have a St. Jude valve that's robust and has a 2-2.5 INR range kind of like the ON-X. My cardio told me there was no real risk for the short term. I had no problems other than bleeding due to the wound opening a little bit a few days after I restarted warfarin, but it was minor.
 

JLmatus

Active member
tom in MO;n883650 said:
I don't know anything specific about implants, but I went off warfarin for a surgical procedure w/o bridging. It went fine. I have a St. Jude valve that's robust and has a 2-2.5 INR range kind of like the ON-X. My cardio told me there was no real risk for the short term. I had no problems other than bleeding due to the wound opening a little bit a few days after I restarted warfarin, but it was minor.
Thanks. That's good to know.
 

pellicle

Well-known member
Good morning

JLmatus;n883648 said:
I need some advice.
...
The Dentist wants me to go off the warfarin 2 to 3 days prior to my dental implant appointments. My Cardiologist says that he will go along with what the Dentist recommends.
...
Studies that I have read seem to suggest that the risk of a blood clot while off warfarin exceeds the bleeding risk while taking warfarin during dental implant while on warfarin.
I agree with your cardiologist and dentist

I had a colonoscopy, which can aggravate bleeding in the intestine of course.

I wrote up my readings and process here

http://cjeastwd.blogspot.com/2017/12...nt-of-inr.html

Like Tom above I didn't (exactly) bridge
 
Last edited:

MrsBray

Premium Level User
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.
 

JLmatus

Active member
MrsBray;n883656 said:
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.
Thanks for the info.
 

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