Dental Implants and Warfarin Therapy

[JLmatus]

I need some advice. My Dentist told me that I need a dental implant. I have an ON-X heart valve and am on warfarin. The Dentist wants me to go off the warfarin 2 to 3 days prior to my dental implant appointments. My Cardiologist says that he will go along with what the Dentist recommends. I am leary about going off the warfarin. Studies that I have read seem to suggest that the risk of a blood clot while off warfarin exceeds the bleeding risk while taking warfarin during dental implant procedures. Has anyone had any expierence with dental implants while on warfarin.

 

[tom in MO]

I don't know anything specific about implants, but I went off warfarin for a surgical procedure w/o bridging. It went fine. I have a St. Jude valve that's robust and has a 2-2.5 INR range kind of like the ON-X. My cardio told me there was no real risk for the short term. I had no problems other than bleeding due to the wound opening a little bit a few days after I restarted warfarin, but it was minor.

 

[JLmatus]

I don't know anything specific about implants, but I went off warfarin for a surgical procedure w/o bridging. It went fine. I have a St. Jude valve that's robust and has a 2-2.5 INR range kind of like the ON-X. My cardio told me there was no real risk for the short term. I had no problems other than bleeding due to the wound opening a little bit a few days after I restarted warfarin, but it was minor.

Thanks. That's good to know.

 

[pellicle]

Good morning

I need some advice.
...
The Dentist wants me to go off the warfarin 2 to 3 days prior to my dental implant appointments. My Cardiologist says that he will go along with what the Dentist recommends.
...
Studies that I have read seem to suggest that the risk of a blood clot while off warfarin exceeds the bleeding risk while taking warfarin during dental implant while on warfarin.

I agree with your cardiologist and dentist

I had a colonoscopy, which can aggravate bleeding in the intestine of course.

I wrote up my readings and process here

http://cjeastwd.blogspot.com/2017/12...nt-of-inr.html

Like Tom above I didn't (exactly) bridge

 

[JLmatus]

I agree with your cardiologist and dentist

I had a colonoscopy, which can aggravate bleeding in the intestine of course.

I wrote up my readings and process here

http://cjeastwd.blogspot.com/2017/12...nt-of-inr.html

Like Tom above I didn't (exactly) bridge[/QUOTE]

Thanks Pellicle.

 

[MrsBray]

My dentist has many patients on warfarin. (Welcome to Florida.) I have an On-X valve, with a target INR range of 1.5-2.5. I had an extraction & implant about 2 years after AVR surgery. I did not change my medication, and I did not have any bleeding issues, even with the extraction. The only thing I would change is request that they do not add the epinephrine to the Novocaine shot. I did not like that one bit. Doc did give me a 10-day antibiotic surrounding the extraction, as well as the standard 2000 mg pre-med for the implant appointments. I am thrilled that the rotten tooth is gone and there is a pretty implant in it's place. I have a feeling that several tooth infections in a row a few years prior to surgery affected the decline rate of my valve.

Side note, I had a breast tissue biopsy that the doctor required me to go off warfarin and bridge with heparin. I did not get the opportunity to speak with the doctor or nurse prior to the procedure, and really wish I had pushed for at least a phone consult. I had an awful time with the heparin shots, and still have marks on my belly 18 months later. I'd like to believe I would have been fine with my lower INR range, but I'm not a doctor.

 

[JLmatus]

My dentist has many patients on warfarin. (Welcome to Florida.) I have an On-X valve, with a target INR range of 1.5-2.5. I had an extraction & implant about 2 years after AVR surgery. I did not change my medication, and I did not have any bleeding issues, even with the extraction. The only thing I would change is request that they do not add the epinephrine to the Novocaine shot. I did not like that one bit. Doc did give me a 10-day antibiotic surrounding the extraction, as well as the standard 2000 mg pre-med for the implant appointments. I am thrilled that the rotten tooth is gone and there is a pretty implant in it's place. I have a feeling that several tooth infections in a row a few years prior to surgery affected the decline rate of my valve.

Side note, I had a breast tissue biopsy that the doctor required me to go off warfarin and bridge with heparin. I did not get the opportunity to speak with the doctor or nurse prior to the procedure, and really wish I had pushed for at least a phone consult. I had an awful time with the heparin shots, and still have marks on my belly 18 months later. I'd like to believe I would have been fine with my lower INR range, but I'm not a doctor.

Thanks for the info.

 

[gimnshuta]

At the end of the day, the decision to go off warfarin for a dental implant is ultimately up to you and your doctors. It's important to weigh the risks and benefits and make an informed choice.