Not sure where to post this

[DebbiN]

I have a question- one of my back teeth broke off tonight, which is very odd for me, my teeth are in really good shape. Anyway, I will have to call dentist on Tuesday. Do you think I will have to discontinue my Coumadin during this time? And has anyone else had these kinds of problems before?? Like I said this is odd for me. I am afraid of infection, I have had endocarditis before. I have an email in to my doctor. I am sure he will want me on antibiotics too.
GRR

 

[Karlynn]

Hi Debbi,
Yes, you will need to be on antibiotics. My guess is that you'll not need to go off the Coumadin. Some people do go off for tooth extraction, but some people don't. If you have a crown done, then you shouldn't need to, just the antib's

Good Luck - just one more thing to mess with, huh.

 

[tobagotwo]

I wouldn't discontinue warfarin, based on the many posts that have been through here.

Did it break off below the gum line? If not, stopping Coumadin would be unnecessary anyway.

There are products at the drugstore you can put on the broken tooth to seal it temporarily. If your doctor doesn't get back to you regarding the antibiotics, you should call and get his service to put you through to his backup. Sooner is better, if they do feel you need them.

I hate tooth problems. Hope it turns out to be a minor repair.

Best wishes,

 

[twinmaker]

I have recently had two root canals and two crowns. The endodontist who did the root canals wanted me off the coumadin so we did bridge therapy with Lovenox. My dentist didn't really think I needed to come off the coumadin for the root canals, but since he wasn't doing them he left it up to the endodontist and my cardiologist. I didn't have to come off the coumadin for the crowns. In all dental situations though, I've had to go on antibiotics whether it's something major or minor like a filling. At least the antibiotic regimen is not as bad as it used to be years ago. Back in the eighties, I had to take oral antibiotics before and after the procedure and also get two injections in my behind. Now it's usually just 2000 mg. of penicillin an hour before the procedure although if it's really invasive like gum surgery (which I've had) I had to take the antibiotics for a longer period of time.

 

[ALCapshaw2]

Check out the Guide to Dental Procedures on AL Lodwicks website (www.warfarinfo.com) - click on "More Information" and then scroll down until you find the link to the Dental Guidelines

I believe a single extraction can be performed while on Coumadin. You may need to get your INR below 3.0 (but above 2.0 or 2.5, I forgot)

If your dentist insists on going off coumadin, either find another dentist or INSIST on Bridge Therapy (Lovenox before and after) until you INR is back to normal.

'AL Capshaw'

 

[MarkU]

I broke a tooth last year. My dentist knows I'm not a "bleeder" so he did the extraction without any changes to my Coumadin, just took Clindamycin beforehand. I kept some guaze on the extraction site for a couple of hours afterwards and everything was fine.
When I went to the oral surgeon to get a post for the replacement crown, I went on half my normal dose of Coumadin (2.5mg v 5.0mg) three days prior, along with the Clindamycin again.
Both my dentist and oral surgeon have been good about consulting with my cardiologist's office about my Coumadin.
Mark

 

[ClickerTicker]

Hi Mark
I had a mitral valve replaced because endocarditis had eaten away at the thing so much that a repair was impossible. I'm pretty sure that I caught the endocarditis via a tooth extraction that was only covered by a single dose of oral amoxycyllin whilst I was waiting for a valve repair.
Now, if I need even a hygenist appointment I have to have intravenous antibiotics prior to the procedure and oral antibiotics a few hours later. In fact my own dentist won't treat me and I have to go to my local public dental hospital for the thing - &Deity knows what else I'm likely to catch there...
If you have a valve replacement and prior endocarditis, this is the standard treatment in the UK.
Be cautious, VERY cautious, and point out your medical history - I'm not sure what happens with a second bout of endocarditis and a valve replacement, but I certainly wouldn't like to find out!
Take care - Ron