Unfortunately, in some cases tooth extraction may become necessary. This in itself is very unpleasant, but many questions may arise for those who receive anticoagulation therapy. Prof. György Blaskó, blood coagulation specialist at the Thrombosis and Hematology Center, explains what to do in such cases.
A slightly bloody condition
Whether for therapeutic or preventive purposes, many people are forced to use various anticoagulants to avoid increased blood clot formation. These drugs work by they push the balance of increased blood coagulation-bleeding in the direction of bleeding. That is why people who take anticoagulants are afraid of tooth extraction – and other dental procedures.
It doesn’t matter what kind of tooth is pulled
What needs to be done, whether or not it is necessary to skip the anticoagulant for the duration of the tooth extraction, depends on how much bleeding the procedure entails. After all, haa tooth is already loose, moreover, it has one root, so there is no need to suspend the therapy, but if the tooth is strongly attached, has multiple roots, and is more difficult to remove, it may be necessary to skip taking the medicine. (All dentists could find out about the duties of a patient receiving anticoagulant treatment before/after dental surgery based on articles written in dentists’ journals.)
It doesn’t matter what anticoagulant you use
It’s worth knowing that it doesn’t matter who uses which anticoagulant, because different preparations have to be done differently, as their mechanism of action, their duration of action, and therefore also their recommendations regarding dental treatment are different. We distinguish the following groups of anticoagulants: heparins/LMWH, coumarin derivatives, new type of anticoagulants (NOAC/DOAC).
INR doesn’t matter
The, anyone taking old-fashioned anticoagulants knows well how important it is to keep the INR level within the expected range (most often 2-3). If it slips out of this interval, it is necessary to modify the therapy. It is important to have the patient’s INR level checked before tooth extraction and other dental treatment, since if it is above 3.5, it is either necessary to switch to a different dose, or to an LMWH injection, or referral to an institution may be recommended. The latter may be necessary especially if the affected person has co-morbidities that also affect blood clotting (e.g. liver disease, kidney disease).
Pay attention to this in the case of NOAC drugs
If you are taking a new type of anticoagulant (NOAC), preferably take the preparation more than 1-3 hours before the dental treatment, but it is best if the dental treatment takes place immediately before taking the medicine. When it comes to the extraction of posterior molar teeth or jaw surgery, a detailed professional description is available, but in such cases it is recommended to switch from NOAC to LMWH 2-3 days before surgery.
Pain relief
The effect of anticoagulants can be influenced by painkillers – he draws attention prof. György Blaskó, blood coagulation specialist at the Thrombosis and Hematology Center. It is therefore worth using metamizole as pain relief instead of NSAIDs (non-steroidal type) after the treatment.
Source: Thrombosis and Hematology Center
Source: www.patikamagazin.hu
