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Heart Disease (Expert Forum)
Coumadin and Gum Bleeding
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Coumadin and Gum Bleeding
by Steven-D-Ostrowsky, Feb 21, 1999 12:00AM
In June 1989 (at age 47)I had a mechanical aortic valve implanted (along with a triple bypass). I take coumadin. Over the last few years, my basic dose has been plus/minus 5 mg per day. My problem is that a night (and sometimes during the day) my gums will start bleeding uncontrollably. Last night was an example. My mouth fills with blood. I ave spoken with both my cardiologist and my denstist and neither seems to have any idea what to do about it. Meanwhile, I continue to have this problem
Besides the loss of blood, I have ruined bed clothing, pajamas, etc. When it happens during the day, it can be very hard to communicate with clients. Face-to-face, they just kind of stare at me as blood begains dribbling out of my mouth. Often, I'm not even aware it is happening until I see the expression on their faces. I feel like they think I'm a vampire.
Are there any suggestions?
Thank you.
Doctor's Answer
by CCF Cardio MD - MTR, Feb 21, 1999 12:00AM
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Dear Steven, thank you for your question. Nathan's suggestions for using an ultrasonic toothbrush may help and his reminder to be careful with oral hygiene is a good one. I wonder what your PT INR level has been while on coumadin. If this level is too high (usually > 3.5), then you may have gum bleeding secondary to anticoagulation that may be too aggressive. Check with your cardiologist regarding this issue. Also, you may have inherent gum disease so I suggest that you see another dentist for a thorough exam of your gums. Otherwise, it's hard to comment without seeing your gums myself. But, I appreciate your predicament and I think you should seek out doctors and dentists until you get a sufficient answer and treatment plan.
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