stopping blood thinners for dental work

[anandbharti]

Hi,
I am currently on the blood thinners,  Efient 10 mg and Aspirin 320 mg after getting a medicated stent  in my LAD  December.
On a recent visit, my dentist recommended  root canal treatment for one tooth. However he will only proceed if I  come off the blood thinners for a few days. Another dentist says it is not necessary to stop the blood thinners . My cardiologist is fine with me coming off these meds for 5 days. Unfortunately, a friend in similar circumstance came off the thinners and had a clotting problem in his coronary artery right on the fifth day.
My question is, has anybody else been through this situation and what course of action they followed.
Thank you very much for the help.

[anandbharti]

Thanks.
Yes, the tooth is not hurting at present so I will go not through the dental work for a while.

[ed34]

My Doctor recommended I consider my heart more than my teeth. However, I was in agony with a broken tooth which required extraction. I told the Doctor that there was no way I could put up with the agony any more and it is likely to become infected. This is the only reason she agreed. If your teeth don't hurt, try to reach the 1 year line taking blood anticoagulants, then you should be fine to have the treatment. Sometimes there is no choice when pain is involved. A few days off the medication is going to be very low risk after 10 months if you are in pain. You will have grown a new artery lining in the stent by now.

[anandbharti]

Thanks for your comments regarding heavy dose of aspirin.

I mentioned it to my new cardiologist and she said since the procedure was done 10 months ago , I did not need such a high dose. I am now on 80 mg aspirin, the Efient dose remains the same at 10 mg.

The lesson learnt: don't be passive,  This is your body after all !
Unfortunately, I can't bring myself to completely stop the blood thinners for the dental work.

[anandbharti]

Thanks for your comments. I will get the INR results before the dental work.
As far as why aspirin and not Warfarin, I don't know.
The only thing I should mention is that I had the stent on December 23 and my interventional cardiologist  went on his Christmas vacation that evening  whilst I  was still in the hospital. May be he was distracted and that's why high dose of aspirin ! Who knows ?  He prescribed Efient because I was not responsive to Plavix.

[purplexbutterfly]

If you are on a high dose of aspirin, wouldn't you be better off taking Warfarin (Coumadin)? And no you don't need to stop your meds as long as you have a stable INR. Dentists should treat you if your INR is under 3.

[kenkeith]

Thanks for your response.  Take care, and I wish you well!

[anandbharti]

Thanks for sharing your experiences, gentlemen.

I used to be on 80 mg for a long time until I had the stent put in last December when the interventional cardiologist increased the dose of  aspirin and added efient.

I will talk to my regular cardiologist about the aspirin dose because  it is almost 9 months since I got the stent.

[kenkeith]

I agree that you may be over medicated on aspirin, and especially if you are having nose bleeds. The danger is internal bleeding (abdomen, bowels, brain, etc) and there may not be any warning until an emergency condition and that could be fatal.  

I take a 80mg aspirin, and had a wisdom tooth pulled.  It took awhile to control the bleeding, but told to bite down on a tea bag to help stop the bleeding. For an internal surgery, it is recommended to be off antiplatelets for 7 days.

Unless your doctor can justify the 320 mg aspirin it may be prudent to reduce to 80 mg.    

[ed34]

That doesn't surprise me. I get occassional nose bleeds with 75mg of each, if I was on 320mg of aspirin I think I would bleed to death.

[anandbharti]

Thanks, Ed.

Yes, I do take 80 mg  x 4 tablets of aspirin. So far no gastric problems but I do suffer periodically from serious nose bleeds.

[ed34]

I came off plavix and aspirin for 3 days. 2 days pre and one day post with no problems.
Are you really on 320mg aspirin a day? that sure is a lot. Does this give you gastric problems?