Warfarin, and even more commonly used aspirin, are potent blood thinners and many people forget or don’t realise the need to tell their dentist they are taking it before undergoing surgery.
Warfarin treatment does not automatically mean you can’t have teeth removed or undergo dental implant treatment. Indirectly though, surgery for anyone on blood thinners can be more complicated because blood will not clot normally and bleeding could be more difficult to stop. However, tooth removal is usually considered minor oral surgery, especially with a minimum of trauma in careful and experienced surgical hands.
The surgeon who assesses your condition should work with your medical doctor to determine the risk and monitor your Warfarin dosage appropriately. Maintaining or reducing your dosage to accommodate minor oral surgery will depend on what condition you are taking the thinners for and the type of surgery you need.
Your medical doctor may reduce your Warfarin dosage based on the PT/INR levels, which together with local treatment (ie stitching) will ensure that you have sufficient ability to stop bleeding and heal well. The key is communication between you, your doctor, and your dentist. It is not considered safe for you to stop Warfarin completely without your doctor’s approval.
For the surgical procedure, your dental surgical specialist will take special precautions to help insure blood clotting and healing after surgery. These include treatment of the surgical site with special haemostatic agents which helps stabilize a blood clot, carefully suturing the gum tissues to reduce the surface area of the wound opening, and putting pressure on the wound edges to prevent the capillaries (tiny blood vessels) from bleeding excessively. It is also common practice to place a bone graft into an extraction socket to replace bone volume, especially important if you are contemplating implant tooth replacement. This graft procedure may reduce the amount of bleeding.
Good pain control and anti-inflammatory medication, together with rest and avoidance of vigorous activity or aggressive irrigation of the wound will all help ensure a comfortable and safe recuperative period.
We will always give you aftercare instructions and provide you with after hours contact details should any concerns arise. You will usually be able to resume Warfarin (or aspirin for those who take it) afterwards under the direction of your doctors.
Be sure to consult with both your physician and dentist or surgical specialist even if you think you are on a low dose of blood thinners.