tooth extraction in patients on warfarin
- for patients on long-term warfarin treatment (e.g. atrial fibrillation, recurrent venous thromboembolism, mechanical heart valves) then the UK Medicines Information (UKMI) says that warfarin does not need to be stopped before primary dental procedures (although the continuation of warfarin treatment increases the risk of bleeding, the risk appears to be minimal)
- an INR should be measured within 24 hours of undertaking the procedure
- the UKMI recommend that no individual should have an dental procedure in primary care if an INR > 4.0 - however British Haematological Society guidelines recommend that the INR should be no greater than two at the time of the procedure (2)
- UKMI also recommend that warfarin patients with renal or hepatic disease or those on chemotherapy or cytotoxics should have dental procedures in hospital
- Pulse (2004), 64 (7), 83.
- MeReC Bulletin (1997), 8(1), 1-4.
Last reviewed 01/2018