Anticoagulants and dental extractions

About anticoagulants

Anticoagulants are blood-thinning medications. They affect how your blood clots. 

If you take anticoagulants, they can increase bleeding during and after certain dental procedures, like biopsies or extractions.

You will need to seek advice on whether you need to stop, or change, your medications before you have a biopsy or extraction.

Seeking advice on anticoagulants

Speak to your dentist before you make any changes to your medications.

Warfarin

If you take warfarin, your dentist may ask for a recent INR test before treatment. (This is a standard test to measure how long your blood takes to clot.)

If your INR is within the target range (usually ≤ 4), you can keep taking warfarin if you are scheduled for most types of dental extraction or biopsy.

Your dentist will use techniques and local measures (like stitches) to control your bleeding.

DOACs (direct oral anticoagulants)

These include:

• Apixaban
• Dabigatran
• Rivaroxaban
• Edoxaban.

For higher-risk procedures (such as biopsies and some dental extractions), your dentist may advise you to delay or skip your morning dose on the day of your dental surgery.

If you usually take your medication in the evening, you do not need to delay or skip your medication.

Antiplatelets

These include:

• aspirin
• Clopidogrel.

You do not need to stop these medications for extractions or biopsies.