|
|
if you take coumadin, is it safe to have a tooth extracted? |
Stroke patient - is taking coumadin (blood thinner). Now he has a problem tooth (probably will need to be pulled). Is there any danger in having this done?
Best answer:
This is a difficult question to answer without a lot more information. One of the most important questions I would have to ask is, "What are the qualifications of your dentist as far as his or her skills at managing the medically compromised patient?"
In my office, I will virtually always work in consultation with the physician who prescribed the coumadin. There is a fine balancing act to perform when you decide whether the risk of discontinuing the coumadin is greater than the risk of removing a tooth while taking coumadin. If the patient is not too far out from the stroke, I would be hesitant to stop the coumadin and I would use two or even three "local measures" to control the bleeding. If the patient has been taking coumadin for a year, I would be more comfortable modifying the dose without fear of precipitating another stroke.
The goal for most post-stroke patients on coumadin is to maintain the INR at about 2.0, but up to 3.0 is acceptable. If a patient has an INR of 3.0 or less, I am comfortable with my abilities to maintain control of bleeding without reducing the coumadin dose. It the INR is over 3.0, then I will consult with the physician about altering the coumadin for a few days prior to an extraction. If I anticipate a more difficult (open flap) procedure, I may strive for an INR of 2.0 or less.
In an emergency, you do what you have to do and unload the entire arsenal to stop the bleeding.
A common regimin is to stop taking coumadin for 3 or 4 days prior to the extraction and then resume it the day following the extraction.
Best answer:
DISCLAIMER: As always, please remember that I have not seen you or your x-rays and I am just speculating so that you might have a better understanding of what questions to ask the person who is actually treating you. I do not know anything about your physical status, any underlying medical conditions, allergies, or other prescription medications you may be taking that you have not disclosed, so I am speaking as if you were a perfectly healthy person with no contraindications for the usual course of treatment. Please always consult with a throroughly informed doctor who knows your case before modifying any prescribed treatment. |
|
