Edmond A. Demirdjan, DDS
You take blood thinners and have a dental appointment in a few days. Should you stop taking taking the blood thinner before visiting the dentist?
Aspirin, Coumadin and Plavix are some of the more popular Anticoagulant medications. Anticoagulants, commonly referred to as “Blood Thinners”, are used in the prevention of blood clots. Some of the less well known blood thinners are Aggrenox, Effient and Pradaxa.
Anticoagulants are very effective and go a long a way in the prevention of life threatening and life altering medical events such as Heart Attacks, Strokes and Pulmonary Embolisms. They are commonly prescribed to prevent blood clots following surgical procedures such as angioplasty or valve replacement surgery. They are also prescribed to patients who are deemed to be at risk for blood clots because of an underlying condition such as Atrial Fibrillation or because they have a previous history of blood clots such as Deep Venous Thrombosis, also known as a DVT.
Coumadin, also known as warfarin, is unique from the other blood thinning medications. Its effects need to be monitored with regularly scheduled blood tests, called an INR, and dosages often need to be adjusted to ensure optimal effect. It can sometimes take months to find the right dose for a patient. Too little is ineffective and too much can be dangerous.
Getting back to that dental appointment you have coming up. In the past it was very common for a physician or a dentist to tell their patient that they should stop taking their blood thinner for a certain time period prior to a dental visit for fear they would bleed too much. Recently we have learned that discontinuing these life saving medications, even for only a short time, can pose significant risks of a heart attack, stroke or other medical emergency. We have also learned that when blood thinners are taken appropriately and when Coumadin levels are in the appropriate range, the risk of “bleeding too much” during most dental procedures is small. Therefore in most cases taking blood thinners is less dangerous than not taking them.
Most dental procedures, including surgery, can be done safely when taking blood thinners. There sometimes are exceptions to this but these are exceptions. Patients should not take it upon themselves to discontinue blood thinners since this may put them in danger of developing blood clots. Inform your dentist of all medications you are taking, including baby aspirin. Your dentist should be able to advise you as to what’s appropriate for your specific situation.
Dr. Edmond Demirdjan is a general dentist in private practice in Middle Village. He is an Associate Fellow of the American Academy of Implant Dentistry and a member of the American Dental Association.