Should I stop my patients warfarin prior to a dental procedure?
Henry I. Bussey, Pharm.D., FCCP, FAHA October, 2005 Because dental procedures pose the risk of bleeding complications for patients on warfarin, some clinicians will opt to have a patient hold his/her warfarin prior to a dental procedure. In our clinic, we do not require patients to stop warfarin prior to dental procedures such as extractions or surgery. Instead, patients are given an aminocaproic acid (brand name Amicar) solution and instructed to hold 10 ml of the Amicar solution in the area of the dental procedure for two minutes just before the dental procedure and every 1 to 2 hours following the procedure until all of the solution is gone. We advise patients not to “swish” as doing so may dislodge a clot. We also advise patients not to do anything that might create negative pressure in the mouth such as sucking on a straw, candy, etc. since this too may dislodge the clot. We mix the Amicar solution in our clinic on the day of the dental procedure for stability and sterility reason
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