If you take warfarin, you’ve probably heard dentists say "stop the blood thinner" before a tooth extraction. That advice can be risky if you don’t know the real rules. Below you’ll find straight‑forward guidance on talking to your dentist, handling bleeding, and deciding when to adjust your dose.
First thing – schedule a quick call with both your dentist and the doctor who prescribes warfarin. Ask the dentist what kind of work you’ll have (cleaning, filling, extraction) and share your recent INR (International Normalized Ratio) numbers. Most dentists want an INR below 3.5 for simple cleanings and below 3.0 for extractions. If your INR is higher, your doctor may lower the dose a few days before the appointment.
Never change your warfarin dose on your own. A short pause can raise your risk of a clot, especially if you have a heart valve or atrial fibrillation. Your doctor can give you a "bridging" plan – usually a short‑acting blood thinner like heparin – if a temporary stop is needed.
On the day of the procedure, bring a copy of your latest INR report. If you’re having a minor cleaning, the dentist can usually proceed without any changes. For extractions, the dentist may use local measures like sutures, gelatin sponges, or a tranexamic acid mouth rinse to keep bleeding down.
After the procedure, keep the gauze pack in place for at least 30 minutes, then bite gently on a clean, moist gauze pad for another 20‑30 minutes. If bleeding continues, a small amount of over‑the‑counter tranexamic acid powder mixed with water can help – but only use what the dentist recommends.
Resume your warfarin dose as soon as the dentist says it’s safe, usually within 24 hours for simple work. Check your INR again in 3‑5 days to make sure the level is back in the therapeutic range. If you notice any unusual bruising, swelling, or blood in your mouth, call your doctor right away.
Finally, keep a medication list handy for every dental visit. List warfarin, any other blood thinners, and supplements like fish oil or vitamin E, which can affect clotting. The more information you give, the better the dentist can plan a safe, low‑bleed treatment.
Following these simple steps – clear communication, proper INR checks, and using local bleeding controls – helps you avoid complications and keeps your heart protected while you get the dental care you need.
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