if you take coumadin, is it safe to have a tooth extracted?

Question

Stroke patient - is taking coumadin (blood thinner). Now he has a problem tooth (probably will need to be pulled). Is there any danger in having this done?

Answer 1

This is a difficult question to answer without a lot more information. One of the most important questions I would have to ask is, "What are the qualifications of your dentist as far as his or her skills at managing the medically compromised patient?"

In my office, I will virtually always work in consultation with the physician who prescribed the coumadin. There is a fine balancing act to perform when you decide whether the risk of discontinuing the coumadin is greater than the risk of removing a tooth while taking coumadin. If the patient is not too far out from the stroke, I would be hesitant to stop the coumadin and I would use two or even three "local measures" to control the bleeding. If the patient has been taking coumadin for a year, I would be more comfortable modifying the dose without fear of precipitating another stroke.

The goal for most post-stroke patients on coumadin is to maintain the INR at about 2.0, but up to 3.0 is acceptable. If a patient has an INR of 3.0 or less, I am comfortable with my abilities to maintain control of bleeding without reducing the coumadin dose. It the INR is over 3.0, then I will consult with the physician about altering the coumadin for a few days prior to an extraction. If I anticipate a more difficult (open flap) procedure, I may strive for an INR of 2.0 or less.

In an emergency, you do what you have to do and unload the entire arsenal to stop the bleeding.

A common regimin is to stop taking coumadin for 3 or 4 days prior to the extraction and then resume it the day following the extraction.

Answer 2

yes do to coumadin been a blood thinner and having to have a extraction there will probably be blood that means you would bleed more than most people and you would have a hard time getting it to stop bleeding.the other thing you could do is explain to your dentist and see what he/she would want to do they will probably want your doctor to either cut your dose for a while or take you off of it for a couple of days but it would not be wise not to tell your dentist that you are on coumadin because then that would be very dangerous.

Answer 3

Important information

You should not take Coumadin if you have a bleeding disorder, blood in your urine or stools, stomach bleeding, an infection of the lining of your heart, bleeding in your brain, recent or upcoming surgery, or if you need a spinal tap or epidural. Do not take warfarin if you cannot take it on time every day.
Do not use Coumadin if you are pregnant, unless your doctor tells you to.
Coumadin increases your risk of bleeding, which can be severe or life-threatening. You will need frequent tests to measure your blood-clotting time. Call your doctor or seek emergency medical attention if you have bleeding that will not stop, if you have blood in your urine, black or bloody stools, or if you cough up blood or vomit that looks like coffee grounds.
Many drugs can cause serious medical problems when used with warfarin. Tell your doctor about all medicines you have recently used.


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Answer 4

i had a tooth extracted at week 16, and was really surprised at how painless it was. talk to your doc. he/she will most likely tell you its fine in the 2nd trimester, but get the OK. she should have novocaine/lidocaine WITHOUT epinepherine, which is basically adreniline. it works just as well during the procedure, but wears off more quickly, which is kind of a plus since we're pregnant and get hungry often--she can probably eat by the time you get home! another difference is that w/o the epinepherine, she may bleed more, though i didn't experience it. the dentist will probably prescribe some kind of antibiotic and may give some painkillers--tylenol w/ codeine is OK during pregnancy, though even though i had a tooth pulled, i didn't even need regular tylenol! if it needs to come out, don't wait much longer. many dentists will tell you the 2nd trimester is the safest, just because of the chance that women farther along could go into labor. there is a risk of infection if you let it go, which can be riskier for her and baby. ***i just want to point out that i went to an oral surgeon for this procedure because he had taken my wisdom teeth out previously and i felt more comfortable with that.

Answer 5

You may want to go to an oral surgeon for the extraction rather than a general family dentist, and have the surgeon consult with the stroke patient's general practitioner. As in most things, better communication will improve the safety.

Answer 6

My mother-in-law has been on Coumadin for 7 years. When she has to have a procedure, they either cut her dosage or take her off it for a couple of days. Talk to the dentist; he'll recommend what changes to make.

Answer 7

yes it is safe, see the dentist and make it clear what medications the patient is on. If necessary they can modify the dosage for a few days and schedule the extraction for later in the week.

Answer 8

Discuss this issue with the oral surgeon/dentist!

Answer 9

YES, YOU MUST TALK TO YOUR HEART DOCTORHE WILL KNOW HOW TO HANDLE THIS, AND LOWER DOSAGE BEFORE EXTRACTION.

Answer 10

not if you tell the dentist first...always tell the dentist what meds you're taking....