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Dental treatment on Wafarin?

  • 23-02-2009 5:09pm
    #1
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭


    Just wondering how well are Irish dentists are trained with treating patients on warfarin? Will/Can a dentist refuse treatment on the basis that I'm on warfarin? Up to what INR range can treatment be carried out ?

    I've not been to a dentist since starting my lifelong warfarin treatment so I've no experience. I'm trying to read through some UK guide books but I can't find anything Irish related.


Comments

  • #2
    davo10
    Closed Accounts Posts: 6,926 ✭✭✭davo10


    routine treatments such as examinations/scalings/most fillings etc do not require special precautions in patients taking warfarin. When having teeth extracted/ deep anaesthetic injections it is recommended that you visit your warfarin clinic/doctor and advise them that you are having invasive dental treatment. They will do blood tests and advise you how long before treatment you need to stop taking warfarin (usually 3-5 days). You may require a longer appointment so haemostasis is confirmed before you are discharged and you are more likely to have a little bruising in region of anaesthetic after treatment.


  • #3
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭Red Sleeping Beauty


    This PDF has helped answer a few questions actually -page 16 in particular.
    It's all relavtive to the UK/NHS though.


  • #4
    Big_G
    Moderators Posts: 1,589 ✭✭✭Big_G


    No need to stop warfarin intake for dental treatment including extractions. INR should be below 3.5 tested within 24hrs of appointment. Adjuncts to haemostasis such as haemostatic sponges, tranexamic acid rinses and such can aid in difficult haemostasis cases. Stopping warfarin can be life threatening. Any surgical procedures should probably be done under the supervision of a specialist or in a hospital setting.


  • #5
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭Red Sleeping Beauty


    So just to confirm - Irish dentists are up to date with warfarin and won't/don't refuse treatment to warfarin patients ? :)


  • #6
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    Any idividual dentist can decide if a patients treatment is within their level of skill and comfort. If they are very woried about bleeding they may well reffer the patient to another dentist or specialist for treatment.

    Most dentists will treat is the INR is below 2.5. For some proceedures have a higher bleeding risk and this may change on a patient by patient basis. Some dentists will do proceedures up to INR=3.5.


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  • #7
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭Red Sleeping Beauty


    Antonio Wooden Marinade wrote: »
    Any idividual dentist can decide if a patients treatment is within their level of skill and comfort. If they are very woried about bleeding they may well reffer the patient to another dentist or specialist for treatment.

    Most dentists will treat is the INR is below 2.5. For some proceedures have a higher bleeding risk and this may change on a patient by patient basis. Some dentists will do proceedures up to INR=3.5.

    Cheers for the reply. Below 2.5 isn't great as my target range is 2.5-3.5.
    Good to know though that Dentists are trained up on it though


  • #8
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    We see lots of people on Warfarin and other anticoagulant therapy. Its no big deal unless you are really badly controlled/. Usually your dentist will liaise with your doctor and get you sorted out.


  • #9
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭Red Sleeping Beauty


    A doctor doesn't control my Warfarin. I go to an Anti-Coag clinic where there's nurses who look after the INR levels etc.
    Don't know how much they know about teeth either actually.


  • #10
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    As long as you know your current INR and its reasonable stale there is no problem below 3.5 for most dental treatment. If it is higher (on purpose) , the doctors in charge can be asked to adjust the coag level for a short period.

    Dentists know a little about the medicine that effect their work. Doctors tend not to be interested in teeth cause they don't really need to, I know I am married to one. ;)


  • #11
    Red Sleeping Beauty
    Closed Accounts Posts: 6,443 ✭✭✭Red Sleeping Beauty


    Antonio Wooden Marinade wrote: »
    Dentists know a little about the medicine that effect their work. Doctors tend not to be interested in teeth cause they don't really need to, I know I am married to one. ;)

    Haha, yeah I've had dealings with Doctors all my life and they usually send anything even remotely tooth related straight to a dentist. Fair enough I suppose. I just really wanted to see what Dentists know .
    I of course know and understand warfarin and my INR and all the baggage that goes with it. Just making sure the dentists do too ;)


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  • #12
    btkm8unsl0w5r4
    Closed Accounts Posts: 9,535 ✭✭✭btkm8unsl0w5r4


    fair play, good luck ;)


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