A tooth extraction on blood thinners is usually done safely without stopping the medicine, because bleeding from a tooth socket can be controlled right where it happens, while stopping a blood thinner can raise your risk of a stroke or clot. The key is planning: telling your dentist about every medicine and supplement, coordinating with the doctor who prescribes it, and using local measures to control bleeding during and after the extraction. Here is how that usually works.
Blood thinners and antiplatelet medicines are prescribed for serious reasons: atrial fibrillation, a past clot in the legs or lungs, an artificial heart valve, a heart stent, a previous stroke or heart attack. A few days without them can let a dangerous clot form. A tooth socket, on the other hand, is small, easy to reach and easy to press on.
That is why, for many simple extractions, the common approach today is to continue the medicine and manage bleeding locally. Whether that applies to you depends on the medicine, the dose, your other conditions and how many teeth are coming out. If any adjustment is needed, such as the timing of a dose on the day of the extraction, that call belongs to the physician who prescribed it, not to you or the dentist alone.
Bring a written list with doses, or the bottles themselves. These are the groups that matter most for bleeding:
At the first visit, Dr. Rana takes X-rays, looks at how the tooth is likely to come out and goes over your medicine list with you. Then the planning usually looks like this:
Most of the work happens before you leave the office. Several local measures are commonly combined:
We check that bleeding is under control before you go home. Local anesthetic keeps you comfortable during the extraction, and oral sedation is available for nervous patients, though it adds to the list of things we coordinate. Our tooth extraction page walks through the visit step by step.
Some oozing and pink-tinged saliva for the first day is normal, and a bruise on the cheek can appear in people on blood thinners. To keep the clot in place:
Call us if bleeding keeps going after two rounds of firm pressure. Go to the ER if bleeding is heavy and won't stop, if you feel faint or dizzy, or if you have trouble breathing or swallowing.
Dr. Rana is a general dentist, and many extractions for people on blood thinners can be done in the office. We refer you to an oral surgeon when the extraction is surgical or the tooth is impacted, when several teeth need to come out at once, when you have a bleeding disorder or significant liver disease, when your INR is unusually high or hard to control, or when you take more than one medicine that affects bleeding. Impacted wisdom teeth often fall into that group. If we refer you, we send your X-rays and medicine list along, so the oral surgeon starts with the full picture.
Dr. Aakash Rana, DDS is a general dentist trained at NYU College of Dentistry, with more than $100,000 in continuing education. He plans and treats each case at Prana Dental himself, works with our in-house lab, and refers to a specialist when a case needs one.
Usually not, and you should never stop on your own. For many simple extractions, the medicine is continued and bleeding is controlled locally with pressure, stitches and dressings. If any change is needed, your prescribing physician decides it.
In most cases, yes. Daily low-dose aspirin is usually continued for a routine extraction, because stopping it can raise the risk of a heart attack or stroke. Tell your dentist you take it so bleeding control can be planned.
Oozing and pink saliva often last most of the first day and can be a little longer than usual. Steady, heavy bleeding that doesn't respond to firm pressure on gauze is not normal and needs a call to the dentist, or the ER if it is severe.
There isn't a single number for everyone. Many simple extractions can be done when the INR is within the usual therapeutic range, but your dentist and physician decide together based on the procedure and your health. A recent test, close to the day of the extraction, is usually needed.
Ask your physician or pharmacist before taking anything. Anti-inflammatory pain relievers can increase bleeding when combined with blood thinners, so a different option is often suggested. Follow the label and the advice you are given.
Call or text (786) 579-0521 with your medicine list handy. We're open, Monday to Saturday, 8am to 8pm.