ChatterBank2 mins ago
Toothache
17 Answers
Last resort!
Son in law having iolent toothhe, he is taking wafarin, the dentist will not treat him because if this.
Any suggestions please!
Son in law having iolent toothhe, he is taking wafarin, the dentist will not treat him because if this.
Any suggestions please!
Answers
Best Answer
No best answer has yet been selected by crosspatch65. Once a best answer has been selected, it will be shown here.
For more on marking an answer as the "Best Answer", please visit our FAQ.It sounds like the dentist is a little behind the times. When a patient is on warfarin, it is the INR that is important, and the recommendations are that primary dental extractions etc can be carried out, without a hugely increased risk of uncontrolled bleeding, providing the INR is less than 4.
http:// www.ukm i.nhs.u k/med_i nfo/doc uments/ Dental_ Patient _on_War farin.p df
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I concur with lazygun. My local health board advises dentists in my area not to perform any extractions or scaling when a patient has an INR of 3.6 or above.
I've raised the issue with a number of haematologists and dental lecturers at my medical school over the last few years and their opinion is that the health board are being ridiculously overcautious.
Yes, sqad is right about potential warfarin drug interaction with other drugs as a patient on warfarin has limited scope to take other drugs at the same time - warfarin interacts with a huge number of drugs including analgesics and antibiotics that might be needed after an extraction. However a good dentist will have assessed this situation beforehand. If the dentist considered that treatment was beyond his expertise, he should indeed refer the patient to a dental hospital or A&E as a matter of urgency.
I'm afraid this constant risk of litigation against the medical and dental professions nowadays is seriously hampering capable and good primary care to the detriment of patients.
I've raised the issue with a number of haematologists and dental lecturers at my medical school over the last few years and their opinion is that the health board are being ridiculously overcautious.
Yes, sqad is right about potential warfarin drug interaction with other drugs as a patient on warfarin has limited scope to take other drugs at the same time - warfarin interacts with a huge number of drugs including analgesics and antibiotics that might be needed after an extraction. However a good dentist will have assessed this situation beforehand. If the dentist considered that treatment was beyond his expertise, he should indeed refer the patient to a dental hospital or A&E as a matter of urgency.
I'm afraid this constant risk of litigation against the medical and dental professions nowadays is seriously hampering capable and good primary care to the detriment of patients.
LazyGun/the prof.
Interesting topic and the advantages of being " non clinical" is that accurate and relevant statements can be made, without having to apply them.
Doctors are well paid and in this sort of situation they are certainly going to " earn their mone."
Whatever the INR, whatever directives and guidelines are applied by professional bodies on is left with a patient in pain and looking to the professions to relieve the pain. relief of pain in medicine is a fundamental principle and if there is a certain amount of danger, then so be it.
crospatch 65 has been badly let down by the dental profession and if he/ she is not careful, the medical profession is about to follow suit.
Interesting topic and the advantages of being " non clinical" is that accurate and relevant statements can be made, without having to apply them.
Doctors are well paid and in this sort of situation they are certainly going to " earn their mone."
Whatever the INR, whatever directives and guidelines are applied by professional bodies on is left with a patient in pain and looking to the professions to relieve the pain. relief of pain in medicine is a fundamental principle and if there is a certain amount of danger, then so be it.
crospatch 65 has been badly let down by the dental profession and if he/ she is not careful, the medical profession is about to follow suit.