Education for Patients on Blood Thinners

If you are taking…

  • Clopidogrel (Plavix)
  • rivaroxaban (Xarelto)
  • dabigatran (Pradaxa)
  • apixaban (Eliquis)
  • Warfarin (Coumadin)
  • Aspirin
  • Other blood thinners as prescribed by your physician/cardiologist.

Please Read the Following:

Pre-Op (Before Surgery)

Some patients may benefit from holding their blood thinner prior to and immediately following surgery. This is to be determined by the patient’s physician/coumadin clinic/cardiologist.

FOR PATIENTS ON WARFARIN/COUMADIN – we will need an INR lab result obtained in the 24 hours prior to surgery.

During Surgery

Our office may use additional measures to address heavy bleeding during surgery such as surgical gel foam or mesh, both of which are absorbed by the body. Cautery may also be used if needed.

Post-Op (After Surgery)

Patients who are taking blood thinners may need to follow a different protocol following oral surgery, especially extractions, to promote proper healing. Some patients on blood thinners will have prolonged bleeding on the day of surgery, while others may experience delayed bleeding 3-7 days after surgery.

Blood thinners may also lead to notable bruising on the face or neck. The best method to address active bleeding is gauze and gentle biting pressure. We will provide extra gauze for you to use at home.

It is important to avoid spitting, smoking, and the use of straws following extraction, as these activities, may disrupt the plotting process.

If you are experiencing PROLONGED bleeding, placing a tea bag (with caffeine) on the extraction site may help to slow bleeding caused by constricting the blood vessels.

A common complication following extractions in patients on blood thinners is a LIVER CLOT. This presents as a dark red and gel-like clot that extends above the gum line. A liver clot is a malformed clot that will prevent proper clotting and should be gently wiped away. After wiping away the liver clot, the socket may begin to bleed again, at this point a normal clotting process can resume. We recommend placing gauze again on the site and biting it down with gentle pressure to help this process.

FOR PATIENTS ON WARFARING/COUMADIN, it is advised to make a follow-up appointment within one week with their physician/coumadin clinic to assess your INR.