Hospital schedule
Taking blood thinners? What to bring before a tooth extraction
When booking a tooth extraction, tell the dentist which antithrombotic medicines you take and why. Bring the full prescription and any existing INR reports if you take warfarin. The dentist will assess the number of teeth, the likely wound size and whether to contact the prescriber.
When booking, say which tooth and which medicines
Tell the dental department which tooth is involved, whether you have X-rays, and whether one or several teeth may need treatment. Give the generic names of your medicines, how you take them and why they were prescribed. Warfarin, apixaban and rivaroxaban are anticoagulants. Aspirin and clopidogrel are antiplatelet medicines. Some people take both types. Bring the packages and your discharge summary so the dentist can check them together.
For example: “I take apixaban for atrial fibrillation and clopidogrel because I have a coronary stent. A lower tooth may need to come out. Who can look at my X-ray and discharge summary first?” If your stay is short, ask whether the first visit is an assessment or might also allow treatment. The dental team will confirm.
What an INR result tells the dentist
The international normalised ratio (INR) helps assess the effect of warfarin. Bring any existing report with its date and mention prescription changes or new medicines since the test. The team will decide whether the result is still useful or a new test is needed.
INR is not used to estimate the effect of direct oral anticoagulants such as apixaban and rivaroxaban the way it is for warfarin. The dentist considers the exact medicine, how you take it and factors such as kidney function. Bring any recent kidney function results with your prescription if available.
Why extractions may be split into visits
Removing one straightforward tooth and removing several teeth or making a gum incision can leave different wounds and require different bleeding control. The dentist may consider separate visits, stitches or packing and will assess whether bleeding has stopped before you leave. Mention past dental bleeding that was difficult to stop, liver or kidney disease, and any combination of antithrombotic medicines.
Beijing Tsinghua Changgung Hospital advises telling the dentist about your medicines and other health conditions. If you take a combination or have a coronary stent, the dentist may also need to contact the prescribing team. Follow the clinicians’ instructions for your own medicines.
Leave with written follow-up details
Ask which department to contact after the extraction, where to go outside clinic hours and what the next review will check. If the dentist prescribes a painkiller or antibiotic, ask them to check it against your medicines. Avoid adding another medicine on your own. Seek prompt dental or emergency care if bleeding does not stop or restarts and is substantial.
Use the Medication checklist before seeking care in China to organise your medicines and keep it with any dental X-rays and test results.
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Related reading
Sources and references
- Beijing Tsinghua Changgung Hospital: Common medicines that can affect tooth extraction
- Scottish Dental Clinical Effectiveness Programme: Bleeding risks for dental procedures
- Scottish Dental Clinical Effectiveness Programme: Warfarin and other vitamin K antagonists
- Scottish Dental Clinical Effectiveness Programme: Bleeding after tooth extraction
- Scottish Dental Clinical Effectiveness Programme: Direct oral anticoagulants
- Scottish Dental Clinical Effectiveness Programme: Anticoagulant and antiplatelet combinations
- Scottish Dental Clinical Effectiveness Programme: Patient bleeding risk factors
- Scottish Dental Clinical Effectiveness Programme: Interactions with dental prescriptions