Advice to patients taking anticoagulation who require dental extraction
Patients undergoing dental treatment who are taking anticoagulants (blood thinner’s) such as warfarin, apixaban, edoxaban, rivaroxaban or dabigatran need to be managed carefully.
Taking an anticoagulant will make your blood take longer to clot, so certain types of dental procedures can cause you to bleed more easily and for longer than patients who do not take anticoagulants.
If you are taking an anticoagulant, it is important that you inform your dentist before any dental procedures are carried out. This is so that your dentist can ensure that going ahead with the procedure will be safe and not cause any prolonged bleeding either during or after the procedure.
If you take the anticoagulant Warfarin, your dentist may ask you to have your International Normalised Ratio (INR) checked before your dental appointment. They will advise on when the INR should be measured, but this is likely to be between 24 and 72 hours before your dental procedure. This is to ensure that your INR is not too high and will not cause a risk of bleeding for too long.
If you are taking one of the Direct Oral Anticoagulants (Edoxaban, Rivaroxaban, Apixaban or Dabigatran), your dentist may need to temporarily stop this or may wish to start your dental procedure early in the day, perform the treatment before your next dose is due (if you are taking a once daily anticoagulant) or treat smaller areas over several visits.
Your dentist will advise you on how to manage your anticoagulants before and after the procedure – there is no need to book a GP appointment to discuss this.
The British Dental Association have produced information for dentists which gives guidance in this area:
Advice to patients taking anticoagulation and an antiplatelet who require dental extraction
If you are on an anticoagulant and are also taking an antiplatelet i.e. aspirin, clopidogrel or ticagrelor, your dentist will need to book a telephone appointment with your GP to discuss.