Tooth Extraction in Patients Taking Blood Thinners: Safe Extraction Planning with DijiDent in Türkiye

The number of people using blood-thinning medications for reasons such as heart rhythm disorders, heart valve diseases, blocked blood vessels, stents or a history of clots is steadily increasing. When these patients need a tooth extraction, their biggest concern is the risk of bleeding. However, stopping blood thinners on one’s own can be much more dangerous, as it can create a serious risk of clots and stroke. Tooth extraction in patients taking blood thinners can be done safely in most cases with correct planning and local measures. As DijiDent Oral and Dental Health Polyclinic, we plan the treatment of these patients in Türkiye in collaboration with their relevant physicians.

Why Are Blood Thinners Used?

These medications help prevent serious conditions such as heart attack, stroke and vascular occlusion by reducing the tendency of the blood to clot. They are basically divided into two groups:

• Antiplatelet medications: Medications such as aspirin and clopidogrel that reduce the clumping of platelets.
• Anticoagulant medications: Medications such as warfarin and new-generation oral anticoagulants that affect clotting factors.

The Most Important Rule: Do Not Stop Your Medication on Your Own

Stopping a blood-thinning medication without permission or changing its dose can lead to potentially life-threatening consequences such as clot formation, stroke or heart attack. In current approaches, many simple tooth extractions can be done safely without stopping the medication, with local bleeding control measures. Only the physician who prescribed the medication decides whether any adjustment to the medication is necessary.

Preparation Before Extraction

• Full medication list: Report all the medications you use, their doses and the times you take them to your dentist.
• Communication with the relevant physician: When necessary, a joint plan is created by consulting your cardiologist or relevant specialist.
• Current tests: For patients using warfarin, an INR value measured shortly before the extraction is important.
• Other health conditions: Liver and kidney diseases and a history of bleeding are evaluated.
• Appointment timing: Morning hours and the first days of the week are generally preferred; this way, the clinic can be contacted easily in the event of a possible problem.

Warfarin and INR

In patients using warfarin, the INR value shows how thinned the blood is. The suitable INR range for extraction is evaluated according to the scope of the procedure and the patient’s condition. If your INR value is markedly above the target range, the extraction may be postponed and your relevant physician is consulted.

New-Generation Anticoagulants

INR monitoring is not required with these medications. In some situations, timing the procedure to coincide with a time when the effect of the medication is lower may be considered; however, such timing adjustments should also only be made with the approval of the relevant physician.

In patients with prosthetic heart valves or certain heart diseases, additional measures to prevent infection may also be considered before the extraction; this decision is made together with your relevant physician.

Measures Taken During Extraction

• Gentle and atraumatic technique: Work is done in a way that causes the least damage to the tissues.
• Local hemostatic agents: Materials that support clotting can be placed in the extraction socket.
• Stitches: Bringing the socket edges together with stitches helps control bleeding.
• Pressure and gauze: Pressure applied after the extraction supports clot formation.
• Staged extraction: If more than one tooth is to be extracted, the procedures can be divided into several sessions.
• Observation: Bleeding control is carried out at the clinic for a while after the extraction.

What to Pay Attention to at Home After Extraction

• Gauze: Bite steadily on the gauze for the recommended period.
• Rinsing and spitting: Avoid vigorous rinsing and spitting on the first day.
• Hot foods: Prefer cold and lukewarm foods on the first day.
• Painkillers: Some painkillers can increase the risk of bleeding; use only the painkiller your dentist recommends.
• Physical activity: Avoid intense activity in the first days.
• Tranexamic acid on the dentist’s recommendation: In some situations, the dentist may recommend an anti-bleeding mouthwash to be used in the mouth.

When Should You Contact Us?

In the event of active bleeding that continues despite proper pressure, the mouth rapidly filling with blood, marked bleeding that restarts days later, dizziness or weakness, contact your clinic. In the case of uncontrollable bleeding, go to the nearest emergency department and be sure to state the medication you use.

Herbal Supplements and Other Medications

Some herbal products and supplements can also increase the tendency to bleed or interact with blood-thinning medications. For this reason, it is important that you also inform your dentist about the herbal products, vitamins and supplements you use. Consult your physician before starting a new medication or supplement in the post-extraction period.

Teamwork

Safe extraction in patients taking blood thinners is possible through the cooperation of the dentist, the physician managing the medication and the patient. At DijiDent, we plan the extractions of these patients in communication with their relevant physicians and by meticulously applying local bleeding control measures.

Frequently Asked Questions

This content is for general information purposes and does not replace an examination by a dentist. Do not stop your blood-thinning medications or change their dose; only the physician who prescribed the medication can make this decision.