![]() ![]() ![]() Your dentist will want you to provide a thorough and complete medical history. An INR of 2.0 roughly means that a person taking this drug takes twice as long to clot than a normal individual. For most medical conditions, the expected range for anticoagulation as measured by the INR is 2.0 – 3.5. The INR is shorthand for “International Normalized Ratio.” It is the primary method that health care providers use to measure the degree of anticoagulation for taking Coumadin (warfarin). Therefore, for each procedure and patient, the risk of bleeding from the dental procedure must be weighed against the risk of harmful blood clot formation from altering the dose or discontinuing the medication. However, both the effect of these medicines on clotting and the potential for bleeding from dental procedures varies between each patient. Most of the time bleeding from dental procedures is not difficult to control and stop, even in patients who are taking blood thinners. Scaling and root planning (deep teeth cleaning) Lovenox (enoxaparin) is used to prevent PE and DVT, and is given through self-injection. However, their anticoagulation activity cannot be monitored as easily as warfarin. There are newer anticoagulants such as Pradaxa (dabigatran), Xarelto (rivaroxaban) and Eliquis (apixaban), which do not need as much time as warfarin to reach full anticoagulation effect, and also to stop that effect when discontinued. In addition many foods and other medications can affect warfarin by either increasing or decreasing activity, therefore the physician needs to frequently monitor (with blood test - See Box to right) for too little or too much anticoagulation activity. For warfarin, it takes several days after the starting of medication to reach full anticoagulation effect, and several days after the medication is stopped for the anticoagulation to stop. Aspirin does this by creating permanent changes in the platelets which last throughout the lifetime of the platelet (7-10 days) which can only be reversed as the body produces new platelets that have not been exposed to the medication.Īnticoagulant medications inhibit the second phase of clotting by blocking production or the function of proteins that stabilize the clot (anticoagulation). The next phase is coagulation when proteins in the blood interact with each other to fill in the spaces between the platelets, stabilize the clot, and make it more solid until bleeding stops.Īntiplatelet medication target the first phase of clot formation by preventing platelets from sticking to each other and to the blood vessel walls. The first involves small blood cells called platelets which clump together at the wound to form a plug which slows the flow of blood through the vessel and forms a matrix. There are two main processes by which the body normally forms a blood clot. However, these medications interfere with the body’s normal clotting mechanism to stop blood flow at a site of tissue injury, which is of concern to dentists for procedures that cause bleeding. Many dental patients are taking “blood thinner” medications for various medical conditions to prevent the formation of potentially harmful blood clots.
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