Tooth pulled (yach...)

[danielgilboa]

I had a tooth pulled yesterday. I own a mechanical St Jude 33mm and maintain a 3.5 INR. The dentist did not think any preparations were required, BUT i am now bleeding on and off for 36 hours. The dentist says go to the hospital. I do not know what they can do there besides let my INR down which is dangarous and anyway, I can do it mayself without the pain of the hospital.

Any experience?
Should I have had the INR dropped prior to the procedure?
I know people on this forum are very militant for maintaining INR levels for mechanical valves even when going through procedures, but how do I overcome the bleeding?

Sorry I haven't been around for long, but I am sure you guys out there have some sensable things to tell me.

Daniel

 

[Ross]

Your INR should have been fine. I might have personnally wanted mine a little lower, but it wouldn't make that much difference. If you've lost an extreme amount of blood, yes go to the hospital, but if it just appears like your losing lots, pack the socket with gauze, do not suck on anything and see if it will stop on its own accord. It's really your call. A little bleeding is one thing, a lot is another.

 

[hensylee]

"but if it just appears like your losing lots" I think Ross meant CLOTS - not lots. If you are losing a stream of blood a hospital visit is in order. There is always some bleeding after tooth extraction, but it isn't supposed to be a steady outpouring of blood. Keep an eye on it.

 

[Barry]

Unless I was losing enough blood to be concerned, I don't know that I'd be going to the hospital just yet. I'd keep it packed with gauze and under pressure and give it another day.

 

[KristyW]

Post Extraction Instructions

Post Extraction Instructions

Daniel,

I work in a dental office & give post extraction instructions quite often. Here's what you should be doing (and not doing).

R I C E

R - Rest - 1st NO RINSING, SPITTING OR SUCKING. No chewing hard things like chips, popcorn etc. Don't brush your teeth either. Wait until all the bleeding stops. (Brushing entails rinsing and spitting.)

I - Ice - (This doesn't apply to you because it's been 36 hours)

C - Compression - Pack the extraction site with gauze and bite on it! Do not remove gauze for at least 2 hours. If the gauze gets blood soaked before that, then go ahead and change it. Try using a regular (not green or herbal) tea bag as packing and bite on it. Something in the tea helps reduce bleeding.

E - Elevation - Keep your head up for the most part. Don't bend over so you're upside down. Try sleeping on a couple of pillows while on your back.

The bleeding should subside fairly soon. The 3.5 might have been a little high for an extraction without "local measures" Local measures include, sutures or gelfoam packing. You'll be ok though. Just be patient.

 

[jeffp]

If the methods mentioned above don't work, there's a vit K based mouth rinse thats used for cases like this. For the life of me I can't remember the name of it (still a bit "pumpheaded" I guess). My daughter has Von Willebrand's disease which causes very delayed blood clotting. Her dentist ordered the stuff at her last dental surgery but didn't need it and keeps it in cold storage for her if needed for future procedures (It was rather expensive if remember correctly). She and I often joke that we'd be doing great if we could swap blood.

 

[danielgilboa]

Thank all.
I tried the pressure and compressions for one more night and still bleeding. now I am 48 hours post and still bleeding, so off I go to the hospital.
I guess I should have been consulting you guys BEFORE the dentist appointment. Next time.

Bye-