Essential Oral Health Tips for Patients on Blood Thinners
If you’re taking blood thinners—whether it's an anticoagulant like Warfarin or a Direct Oral Anticoagulant (DOAC) like Apixaban, Rivaroxaban, or Dabigatran—managing your oral health requires careful consideration. These medications are crucial for preventing dangerous blood clots, but they can increase your risk of bleeding, especially during dental procedures.
Prioritising Prevention and Disclosure
The most important step is prevention. Excellent daily oral hygiene is your first line of defense. Bleeding gums from gingivitis or periodontal disease are more common and harder to manage when you're on these medications.
Maintain Pristine Hygiene: Be diligent about brushing twice a day with a soft-bristled brush and flossing daily. Good hygiene prevents the infections and inflammation that lead to bleeding.
Tell Your Dentist Everything: Always inform your dental team about all medications you're taking, including over-the-counter painkillers like ibuprofen (NSAIDs) or even herbal supplements, as these can also affect blood clotting.
Dental Procedures and Bleeding Risk
Routine check-ups, cleanings, and simple fillings usually pose a minimal bleeding risk and can typically be performed without adjusting your medication. However, procedures that may cause bleeding—such as tooth extractions, root planing, or minor oral surgery—require careful planning.
Do Not Stop Medication on Your Own: The risk of a life-threatening clot (thromboembolic event) from stopping your blood thinner for a dental procedure far outweighs the risk of bleeding in the dental chair. Never discontinue or change your dosage without explicit advice from your prescribing doctor and dentist.
For Warfarin Users: Your dentist will likely need your most recent INR (International Normalised Ratio) blood test result, usually taken within 24–72 hours of the procedure. For most minor procedures, an INR below 3.5 is generally considered safe.
For DOAC Users: Your dentist may simply advise you to take your last dose of medication 24 hours before your morning appointment, ensuring the drug’s level is at its lowest (trough concentration) during the procedure.
Your dental team will manage any potential bleeding using local measures like suturing, packing the socket, or applying special clotting agents, all to ensure your safety while maintaining your overall health.
