doyo said:
I posed the same question to both my wife's cardio and also her PCP about the tooth extractoin.
The cardio said, stop warfarin, go onto Lovenox.
The PCP said, for a simple extraction, keep taking warfarin.
The PCP said he got into many arguments with his patients' dentists over this issue. It seems dentists would rather have you end up with stroke than a little bleeding.
What the PCP said agrees with what I read elsewhere.
What the cardio said seems a bit extreme for a simple extraction.
EJ
From Al Lodwicks treasure chest of info:
Do you need to stop warfarin before a dental procedure? The January 2000 edition of the Journal of The American Dental Association published a study of 950 people who had 2,400 dental procedures done. None of these people stopped their warfarin. There were only 12 incidents (about 1% of the time) where anything more than holding a pad with slight pressure was required to stop bleeding. In these 12 incidents, only 3 times was the INR at or below the therapeutic level. The author also studied 526 people who stopped their warfarin for 575 dental procedures. There were 5 serious complications (about 1% of the time). However, 4 of these 5 patients died.
The conclusions drawn from the study:
Serious complications, including death, were 3 times more likely to occur if warfarin was stopped than if it was continued.
Stopping warfarin for dental surgery is not based on scientific fact, but is a myth.
The author recommends:
Continuing warfarin at therapeutic levels for dental procedures.
Having the patient's INR checked before dental procedures.
What should you do?
Be certain that your dentist is aware of this important information before having a dental procedure.
Question the need for stopping warfarin if you INR is in your goal range.
Show this to your dentist, it contains the reference the dentist will need to find and read the entire article.
Reference: Wahl MJ. Myths of Dental Surgery in Patients Receiving Anticoagulant Therapy. J Am Dental Assoc 2000 Jan;131(1):77-81.
See Also
