Blood Thinners and Tooth Extraction: What To Tell Your Dentist

What should you tell your dentist before a tooth extraction?

Tell your dentist about every medicine you take. That includes blood thinners, aspirin, other prescriptions, vitamins, and supplements. Cleveland Clinic says to be sure to tell your dentist about any medications, vitamins, or supplements you take. Mayo Clinic adds that some of them may cause problems with blood clotting.

Do this at your first visit and again before any surgery, even when you think your records are current. Bring a written list of names, doses, and the reason you take each one. Say when you last took them. This helps the team plan a tooth extraction around your health.

Should you stop your blood thinner?

No, not on your own. Please do not stop, skip, or change a dose of any medicine because of a dental visit unless your doctor tells you to. This post cannot tell you what is right for you.

Here is what the American Dental Association says in its review for dentists and doctors. Any suggested change to the medication plan before dental surgery should be made in consultation with, and on the advice of, the patient’s physician. The review also says there is general agreement that in most cases, older blood thinners and antiplatelet drugs should not be altered before dental procedures. It explains the reason too. Without these medicines, patients face a higher risk of blood clots, which could lead to stroke or heart attack.

That is a summary of a clinical review. It is not advice for you. The right plan depends on why you take the medicine, which one it is, your other health conditions, and how complex the extraction is. Your doctor and your dentist decide this together. Call your doctor’s office, tell them the date and type of dental work, and ask them to speak with your dentist if needed.

Why do people take these medicines?

The ADA review explains that blood thinners are prescribed for people at high risk for blood clots or who have had them. That includes people who have had a clot in a deep vein or the lungs, and people with an irregular heartbeat called atrial fibrillation, which raises the chance of clots. The review also says antiplatelet drugs are used by people who have had a heart attack or have had a stent placed in a heart artery.

These are serious conditions. This is why your dentist wants the full picture and why the choice about your medicine belongs with your doctor.

What medicines does the ADA review cover?

If your medicine is not on this list, tell your dentist anyway. The list is not complete. Over-the-counter aspirin counts, so mention it too.

How do dentists manage bleeding?

The ADA review says bleeding after dental work in these patients can be controlled with local measures. Those measures include firm pressure, special dressings that help a clot form, stitches, and in some cases a medicine that helps keep the clot from breaking down. Your dentist chooses the steps that fit your case.

The review also notes some other health conditions can raise the risk of longer bleeding, such as liver or kidney problems or blood disorders. In these cases dentists may consult your physician first. So tell your dentist about your full health history, not only your blood thinner.

What can you do at home after the extraction?

Follow your dentist’s written steps, and use these basics from Cleveland Clinic:

1. Fold a piece of gauze and place it over the site. Bite down gently for 15 minutes. Repeat as needed. Our glossary explains gauze pressure.
2. Expect to ooze small amounts of blood the first night. Cleveland Clinic says this is normal.
3. Skip strenuous exercise for 48 to 72 hours. A faster heart rate can cause more pain and bleeding.
4. Do not poke at the site or rinse hard, since this can dislodge the protective blood clot.

For people who take blood thinners, MouthHealthy says these medicines may cause gums to bleed and to contact your physician if the bleeding does not stop quickly. If firm pressure does not slow the bleeding, call your dentist or your doctor right away.

What if you also have other health conditions?

Mention them. The ADA review lists several that can raise the chance of longer bleeding after dental work: liver problems or heavy alcohol use, kidney failure, low platelet counts, hemophilia and other blood disorders, and cancer chemotherapy. If you have one of these, your dentist may want to talk with your physician first. Health history is part of the plan, not an extra.

What questions should you ask?

• Should I talk to my doctor before this extraction?
• Which steps will you take to control bleeding?
• What should I do at home if the site bleeds?
• Whom do I call, and what do I do if the office is closed?

The last question matters. Town Center Dental is closed Friday through Sunday, so ask what to do if you need help when the office is shut. For more on aftercare, see our tooth extraction aftercare guide and our post on dry socket. See the entry on post-operative instructions for how to read your aftercare sheet.

Next step

Learn about tooth extraction at Town Center Dental. Before your visit, make a list of your medicines and talk with your doctor. Then call (636) 273-5866 or request an appointment and tell the team about every medicine you take.