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A 23-year-old male asked:

what should a patient of pph (age:46 , with inr target 2-3) do, with dosage of warfarin, if she has to undergo tooth removal treatment?

3 doctor answers10 doctors weighed in
Dr. Scott Bobbitt
Dentistry 32 years experience
Consult all docs: Talk to your physician and dental surgeon. Warfarin only limits one of the pathways to form a clot--in most cases, simple 'first aid" pressure will stop bleeding after tooth removal. A warfarin "holiday" can triple the risk of a clotting event, and may not be indicated. The doc may consider to lower your inr and/or utilize a vacuum-formed socket compression appliance. Best to ask ?S first.
Dr. Ehsan Ansari
Cardiology 30 years experience
Depends on dentist: If your dentist is comfortable with your Coumadin onboard then you may proceed. However if he is not comfortable then you need this to discuss with your physician who manages your warfarin.
Dr. Shahid Rafique
Internal Medicine 44 years experience
Usually dental extraction is not a problem when the INR is around 1.5. INR in that range for a day or so does no significantly increase your risk in PPH. In your particular case your cardiologist is the best judge if that would be safe.
Oct 7, 2013
Dr. Tarek Hamid
Dentistry 9 years experience
Stop for 1 to 2 days: You can stop the warfarin tx. For one to two days prior to surgery with the consent of your physician . To minimize post operative bleeding. And also bleeding during the surgery.

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Last updated Sep 28, 2016

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