Quick answer
Do not stop aspirin, warfarin, clopidogrel, apixaban, rivaroxaban or another blood thinner on your own. For most patients and many dental procedures, treatment can proceed with local bleeding-control measures. Higher-risk patients or extensive surgery may require coordination with the prescriber.
Key takeaways
- Never stop or reduce a blood thinner without medical direction
- The risk of a clot can outweigh manageable dental bleeding
- Accurate medication information is essential before treatment
Why stopping can be dangerous
Anticoagulants and antiplatelet medicines reduce the risk of stroke, heart attack and other serious clotting events. Interrupting them without a coordinated plan may create a greater danger than the dental bleeding the change was intended to prevent.
What the evidence says
The American Dental Association reports that, for most patients, anticoagulant or antiplatelet therapy does not need to be altered before dental intervention. Dentists often control bleeding with pressure, sutures, local hemostatic materials and other site-specific measures.
The exact plan depends on the medicine, dose, kidney and liver function, other medical conditions, the procedure and the consequences of bleeding. More extensive surgery or a higher-risk medical history may require consultation with the prescribing clinician.
What to bring to the appointment
- The exact medication name, dose and schedule
- Why it was prescribed and who manages it
- Recent INR results if you take warfarin and were instructed to have testing
- A complete list of prescriptions, over-the-counter drugs and supplements
- Any history of prolonged bleeding, kidney disease, liver disease or blood disorder
After treatment
Follow the office’s written instructions closely. Avoid disturbing the area, use gauze as directed and call if bleeding does not steadily improve. Severe uncontrolled bleeding, fainting, confusion, breathing difficulty or rapidly expanding swelling requires emergency medical care.
Sources
This article is educational. Never change a prescription without direction from the clinician who manages it.