posted: Aug. 07, 2015.
Dental work isn’t performed in a vacuum — the state of your general health can have an impact on procedures and vice-versa. This is especially true if you’re taking certain medications like blood thinners.
Blood thinners such as Warfarin or Clopidogrel are used for a number of medical conditions as an anti-coagulant (inhibiting blood from clotting). They’re commonly part of a stroke or heart attack prevention strategy in patients with cardiovascular disease, or those with tendencies for thrombosis (blood clot formation within blood vessels) or pulmonary embolisms (blood clots within the lungs). They’re also used with patients with artificial heart valves or on a temporary basis with patients who’ve recently undergone knee replacement or similar surgical procedures.
In most cases, dental work won’t be affected by your use of a blood thinner. An issue might arise, however, if an invasive procedure has the potential to cause bleeding, like a tooth extraction or gum surgery. Because the blood doesn’t clot normally it may be difficult to stop the bleeding during such procedures.
To avoid undue complications, it’s always best to let your dentist or oral surgeon know what medications you’re taking, especially blood thinners (this includes low-dose aspirin, a common over-the-counter drug that’s often prescribed as a mild blood thinner). Depending on the procedure and your dosage, they may consult with your prescribing doctor to see if temporarily stopping the medication or reducing the dosage is an acceptable precautionary measure for your dental treatment. Your dentist may also take precautions during the procedure to help reduce bleeding such as using haemostatic agents around the wound site to help stabilize blood clotting, while carefully suturing the wound to avoid disrupting smaller blood vessels (capillaries) that easily bleed.
If your dosage has been temporarily stopped or reduced, you’ll usually be able to resume blood thinners immediately after the dental procedure. Working together, your dentist and doctor will help ensure that your health won’t be at risk and your dental procedure will occur without undue complications.
If you would like more information on dental work precautions with medications, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Surgery & Blood Thinners.”
Many people take “blood thinner” medications to prevent the formation of potentially harmful blood clots. Though these powerful drugs protect against stroke, heart attack, deep vein thrombosis (DVT), pulmonary embolism (PE), and other life-threatening events, they also interfere with the body’s natural ability to stop blood flow at the site of tissue damage. Therefore, it is imperative that you advise your doctor before having any procedure that may induce bleeding. Dental procedures, including oral surgery, tend to cause bleeding, and a patient’s inability to form clots is of great concern.
Antiplatelets vs. Anticoagulants
There are essentially two types of FDA-approved blood thinners* on the market:
- Antiplateletmedications (i.e., aspirin, Ticlid [ticlopidine], and Plavix [clopidogrel]). These drugs target the first phase of clot formation, preventing platelets from adhering to each other and to the blood vessel walls.
- Anticoagulantmedications (i.e., Coumadin [warfarin]). This type inhibits the second phase of clotting, blocking the function of proteins that stabilize the clot, or anticoagulation. Other such drugs are Pradaxa (dabigatran), Xarelto (rivaroxaban), Eliquis (apixaban), and Lovenox (enoxaparin).
*Since new drugs are introduced regularly, if you do not see your medication listed here, check with your physician to confirm if you are indeed taking a blood thinner.
Your dental practitioner may conduct some tests before your treatment and consult with your doctor before performing a procedure. Your healthcare team will likely do one of three things:
- Advise you to continue taking the medications as usual
- Change the dosage or type of medications
- Advise you to stop the medication before the procedure
Additional precautions may be taken before, during, and after the dental procedure to reduce the risk of excessive oral bleeding. Never discontinue or alter your medications without the advice of your physician and dentist.
FAQs About Blood Thinners and Oral Surgery
Should I check my clotting times before a dental appointment?
Depending upon the type of medication you are taking and the type of dental procedure, you may need to obtain specific blood tests shortly before your visit. This will give your doctor an idea of how your medication will affect your ability to clot after the procedure.
Shouldn’t I stop my blood thinners before a dental visit, just to be safe?
Cases show that the risks of discontinuing these medications can be very dangerous, and many studies have proven that serious bleeding from most dental procedures, even while taking blood thinners, is very rare. Also, bleeding can be controlled in the dental office using stitches, socket packing, etc. Therefore, even with surgical procedures, these life-saving medications are seldom stopped, except in certain patients who have an increased risk of bleeding.
What measures can I take to minimize bleeding after oral surgery?
Apply pressure on the bleeding sites for 30 minutes with moist gauze or tea bags. You should refrain from spitting, rinsing, using a straw, drinking hot beverages, and smoking for at least the first 24 hours. Also, avoid hard or sharp foods like pretzels or chips for the first two to three days. Your dentist may also prescribe medications that can minimize bleeding.
For more than 50 years, Innovative Oral Surgery & Dental Implants has provided personalized, patient-centered care in Feasterville-Trevose, Newtown, and Jenkintown, Pennsylvania, and the surrounding areas. Our professional team will relieve your pain and restore your smile using the most state-of-the-art techniques available. Contact us today to schedule an appointment.
Additional Information Regarding the Impact of Blood Thinner Medication on Oral Surgery:
- American Heart Association, What are Anticoagulant and Antiplatelet Agents? //www.heart.org/idc/groups/heart-public/@wcm/@hcm/documents/downloadable/ucm_300338.pdf
- American Stroke Association, Anti-Clotting Agents Explained