If you take a blood thinner and have been told you must stop it before dental surgery, that advice may well be out of date, and stopping it can be considerably more dangerous than the bleeding it was meant to prevent.
What current guidance says
For routine dental surgery, including most extractions and implant placement, contemporary guidance generally advises continuing anticoagulation. The risk of a clot from stopping it exceeds the risk of bleeding from continuing.
That represents a genuine reversal from what many patients were told years ago, and a lot of people are still operating on the old advice.
Why bleeding is manageable and clots are not
Bleeding in the mouth is visible, accessible and controllable with local measures: pressure, sutures, haemostatic agents, tranexamic mouthwash. It is inconvenient rather than dangerous.
A stroke or a pulmonary embolism from interrupted anticoagulation is neither visible nor reversible. The asymmetry is stark.
What we need to know
Which drug, what dose, what it was prescribed for, and who prescribes it. Warfarin, the newer direct oral anticoagulants and antiplatelet agents each behave differently.
For warfarin, a recent INR is useful. For the newer agents, timing the appointment relative to your dose sometimes helps and is decided case by case.
The one rule that matters
Never stop or adjust anticoagulation yourself before a dental appointment. If a change is appropriate, it is made by the prescribing physician in consultation with us, not unilaterally the night before.
Patients doing this on their own initiative, believing they are being helpful, is a real and avoidable danger.
Bring the full details to the assessment and let us coordinate with your physician. In most cases nothing needs to change at all.
Questions about your own case? Send us your photos and we will walk you through the options.
