I have read several members saying they take Coumadin (Warfarin) so I thought I would relay a recent dental excursion for a simple extraction. Molar broke exposing a nerve I guess, hurt quite a bit, this on a FRiday evening. I called the VA Telenurse to get advise about stopping the Coumadin until the tooth was pulled. 3 days of not taking it and I should be fine, so I made my appt accordingly. Just a small side note, my regular dentist had retired so I googled for a clinic near me and low and behold there was one that claimed "Painless Dentistry". Sounded like my kind of Dentist. His ad lied.He did compliment me on how well my root to this tooth had attached itself to another bone as he he sawed and cut. And drilled. He was standing on a little stepstool to get better leverage and after an hour the last remnant Popped (literally) and he said he was done. Neither he nor his asst. could understand me due to the suction thing in my mouth and more Novacaine than I have ever had. It's good they couldn't.Now the Coumadin. It took three days for the bleeding to stop. My pillow cases look like I had some kind of ritual on them. At least I know it works. Just be prepared to bleed a little extra before things get back to normal.And don't trust the Painless Dentists.

Just a side note. If you ever need a tooth extracted in the future, see an oral surgeon, and not a general dentist. It makes a world of difference, and the price is not much different. I know from experience....

Thanks Tucson Jim, Point well taken.

Sounds like you should have had a clotting test done before the extraction was done. If your clotting time was in the proper range, you should not have experienced that much bleeding. In my book, the primary criticism of the dentist would be that he didn't require the clotting time to be determined before undertaking the surgery. I spent 14 years doing urgent dental care (thousands of extractions) exclusively. I know whereof I speak. T. Waugh, DMD

I did tell him about the Coumadin and how long I had stopped taking it but there was no test. A box of gauze he gave me and three more I bought. Thank you for your response Doctor. I am not sure how they balance out the risk of my blood being too thick and me throwing a stroke or bleeding.

another one to add to the oxymoron list, "painless dentistry". Jim's comment reminds me of years back when I had a molar removed, half way through the dentist said "I should have sent you to an oral surgeon". Not reassuring at all. :)bumpy

Coumadin and Dentistry | Good Sam Community

TucsonJim
Explorer II
Sep 23, 2015
Just a side note. If you ever need a tooth extracted in the future, see an oral surgeon, and not a general dentist. It makes a world of difference, and the price is not much different. I know from experience....
rwj146
Explorer
Sep 23, 2015
Thanks Tucson Jim, Point well taken.
punomatic
Explorer
Sep 23, 2015
Sounds like you should have had a clotting test done before the extraction was done. If your clotting time was in the proper range, you should not have experienced that much bleeding. In my book, the primary criticism of the dentist would be that he didn't require the clotting time to be determined before undertaking the surgery. I spent 14 years doing urgent dental care (thousands of extractions) exclusively. I know whereof I speak.

T. Waugh, DMD
rwj146
Explorer
Sep 23, 2015
I did tell him about the Coumadin and how long I had stopped taking it but there was no test. A box of gauze he gave me and three more I bought. Thank you for your response Doctor. I am not sure how they balance out the risk of my blood being too thick and me throwing a stroke or bleeding.
Bumpyroad
Explorer
Sep 23, 2015
another one to add to the oxymoron list, "painless dentistry". Jim's comment reminds me of years back when I had a molar removed, half way through the dentist said "I should have sent you to an oral surgeon". Not reassuring at all. :)
bumpy
Scottiemom
Nomad
Sep 23, 2015
DH was on coumadin for 12 years. He was required to stop his coumadin 10 DAYS before extractions. He had quite a few because radiation from cancer treatment has ruined his teeth. Always stopped 10 days before and never a problem. No excessive bleeding, etc. He was also on aspirin and stopped it at the same time.

He now is off coumadin but still takes the aspirin. Had a double extraction last year and stopped his aspirin 10 days ahead. Smooth sailing.

So next time. . . check with your doctor, but he will probably suggest you stop it 10 days in advance.

Dale
zigzagrv
Explorer
Sep 23, 2015
If you have an artificial heart valve, stopping Coumadin is a serious situation and should be monitored closely during any type of surgery. If PT/INR drops too low, a stroke is possible. If you are taking Coumadin for AFIB, stopping for several days is not as serious a problem.
rwj146
Explorer
Sep 23, 2015
I just got back from the VA and having my ProTime test done and the nurse said the same thing about 10 days if you can schedule it. Mine was sort of an emergency...Ron I have AFIB. Thanks to all who responded.
vic46
Explorer
Sep 23, 2015
OP do you not regularly have an INR test done to determine the clotting response in your blood. I too have AFIB and I have the test done regularly. The interval time is dependent on the last INR factor. I have on occasion done two tests per week as the INR factor was outside the acceptable range. My normal testing interval is one to three weeks. In the event I am having any kind of invasive procedure, the coumadin is terminated for a period of time that is usually 5 days in advance of the procedure and several days after. If the procedure is a very serious the coumadin is replaced with heparin or a heparin derivative, self administered for 5 days before the surgery. The anti-coagulation effect of the heparin can be reversed with an injection. Not so with the rat poison (coumadin)!
rwj146
Explorer
Sep 23, 2015
vic46, yes they (the VA) will retest me weekly if my level gets out of range. I've had two surgeries and both times they have cut off the coumadin and gave me a self injecting anticoagulant called Lovenox. Then when in the hospital I had a heparin drip. I didn't know about the ability to reverse the heparins affect. When I was released I was back on the coumadin and had to do the Lovenox injections for a week. I have inquired about Pradaxa (sp) or another thinner and The Veterans Administration has just started to allow them to be prescribed. I may stick with the rat poison, at least I know the disadvantages of it.

I have learned some new things today and at my age that makes for a good day. Thanks everyone.