I saw a dentist last week for a toothache, and she suspects that I need root canal treatment for a tooth with an old filling that is loose. I completed the new patient paperwork and gave my prescription information. The dentist referred me to an endodontist and told me she would transfer my records to remind the dentist that I take Eliquis. She said the procedure should go smoothly, but I shouldn’t take any chances. Now, I am more nervous than usual. I always need sedation before a procedure. Is there any way we can replace the filling and skip the root canal? – Thanks. Kandace from Lansing, MI
We understand your concerns. Dentists and other healthcare professionals ask for your medical and prescription history to provide safe, efficient care.
Should You Skip a Root Canal If You Take ELIQUIS®?
You should not skip a root canal if you take ELIQUIS® or other anticoagulant medication. Without root canal treatment, the tooth infection will thrive, potentially affecting your gums, jawbone, other teeth, and overall health. The American Dental Association confirms that, in most cases, patients do not need to discontinue anticoagulant or antiplatelet medication. However, patients with high bleeding risk should consult their medical doctor for advice.
How Can Eliquis® and Other Blood Thinners Affect Dental Procedures?
Eliquis® and other blood thinners can affect the blood clotting process. Consider how:
The blood clotting process has two phases
- Platelet bonding – These small red blood cells stick together and adhere to blood vessels to slow blood flow.
- Coagulation – Protein chemicals in the blood interact, fill in the gaps between the clumps of platelets, and form a solid clot to help the bleeding process stop.
The purpose of antiplatelet and anticoagulant medication
- Antiplatelet agents – These agents prevent the first phase—platelet bonding.
- Anticoagulant agents – These agents prevent the second phase—the formation of protein chemicals that give the clumps of platelets a stronger bond.
How Can Antiplatelets or Anticoagulants Affect Dental Procedures?
Many dental procedures can produce bleeding. However, bleeding is usually minimal, even when patients take antiplatelet or anticoagulant medication. Your dentist or oral surgeon will consider the risks of performing a particular procedure while the medicine is in your bloodstream versus when you have not taken the medication.
Some dental procedures that can cause bleeding are:
- Dental implant placement
- Periodontal (gum surgery)
- Regular and deep dental cleaning
- Tooth extraction
Each patient’s case is unique. In some cases, discontinuing the medication is very dangerous. You should not automatically stop taking ELOQUIS® or other anticoagulants before a dental procedure without your doctor’s approval. Continually update your dentist and medical doctor with any medication changes.
Medication Precautions Before a Dental Procedure
Your dentist or endodontist will take precautions to minimize bleeding and give you aftercare instructions to help prevent excessive bleeding. Follow the instructions closely. For example, after surgical treatment, you will be advised to avoid smoking, drinking from a straw, spitting, and rinsing your mouth for at least the first 24 hours. Sharp, sticky, and hard foods should be avoided because they can aggravate an oral surgical site and dislodge blood clots.
Some herbal-based products can interfere with—or enhance—the effects of antiplatelet or anticoagulant medication. So, include them all in your list of medications and supplements.
During your consultation with the endodontist about a root canal, explain your anxiety and sedation needs. Also, ensure the specialist has a list of medications and supplements you take.