I had attended a seminar at Henry Ford Hospital which discussed the use of anti-coagulants (blood thinners) and what should be done for those patients who are in need of dental treatment where bleeding will occur.  This information is critical because I am sure there are many seniors who are reading this article who are on Plavix, coumadin, and aspirin.  I can say that when I call up a physician to determine if a patient needs to be taken off of their medication there is a lot of misinformation and confusion.

The reason why some people take blood thinners is to prevent clots and therefore  prevent strokes and heart attacks.  For maximum patient safety a blood test is needed before dental treatment is done to make sure prolonged bleeding won’t be a problem.  The INR readings need to be from 2-3 to safely treat the patient.

Assuming the INR readings are from 2-3;

  1. There is NO need to take patients off of their blood thinner medications for routine extractions, gum surgery, deep periodontal cleanings and regular cleanings.
  2. For some invasive treatments it may be necessary to take patients off of coumadin.  If so, they need to be taken off of the medication 4 days before the procedure and then have injections of heparin until the invasive dental treatment is performed.  All of this is monitored by their cardiologist or specialty department at the hospital.  Potential life threatening problems exist if patients are taken off of the coumadin and then restarted without special medications used.
  3. The dentist can use local agents such as thrombin gauze and sutures to enhance bleeding in areas where teeth are extracted.


This information is new and should be followed to treat patients most safely, preventing potential future strokes and heart attacks (thrombosis).

Shelby Township, Michigan Dentist Explains Blood Thinners and Dentistry