Anticoagulation and dental procedures

ANSWER: Warfarin should not be stopped before minor dental surgery, including tooth extraction, but a decision to proceed should be based on whether a patient’s INR is well controlled.1,2 Stopping warfarin unnecessarily in patients requiring anticoagulation may put them at increased risk of thrombotic events..1

Request an INR test 24 hours before surgery. For patients with an INR above 4, surgery should not proceed.1 For patients with an INR in the range 2.2 to 4.0, the procedure can be performed but it is recommended the

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