Pre-extraction or Surgical Procedure Instructions
Extractions can be quite a traumatic experience for everybody so it would help to understand the procedure and be prepared for it. As such, these are some suggestions to help it be an easy extraction:
Kindly wear less makeup and lipstick so that we can make sure that the surgeon can see the colour of the skin tone of the skin/face/lip.
Wear dark-coloured clothes without a collar to avoid any spillages or staining of the clothes.
If you are a smoker, try to avoid smoking for at least 24 hours before and after, but it would be in your best interest to avoid smoking for 1 week both before and after surgery.
Brush the area really well, especially if there are teeth in front and behind the tooth to be treated, for at least a few weeks leading up to the extraction.
Have some food at least an hour before the extraction. You will be numb after the procedure and will not be able to eat immediately afterwards. Use the toilet before the appointment to ensure your comfort during the appointment.
If you are nervous about the extraction kindly let the surgeon know. There is an option where we can give you a prescription for an anxiety pill, Diazepam. This is usually prescribed as 3 doses: 5mg the night before the appointment, 5mg the morning of the appointment and 5mg 1 hour prior to the appointment. If you would like this it is also advised that you be taken home by somebody after the appointment as it would not be advised to drive, use any machinery, sign important papers or look after anybody, after taking the medication.
If you are on blood thinners:
Aspirin/Clopidogrel–there is no need to change the dose, or no precaution needed. We would deal with any possible bleeding as a part of the treatment.
Warfarin–if you are on warfarin we will need to have your INR be within the range of 2-3 and less than 4, 24 hrs before the procedure. If the INR is stable for the past 1 year, then a reading within 72 hrs is acceptable(according to dentist discretion) for us to proceed with the extraction in surgery.
Apixaban /Dabigatran -Taken usually twice a day - we advise you to miss your morning dose and to take your next dose at your usual time in the evening. If it is only an evening dose, then there is no need to change the regime prior to your extraction and only a morning dose you can skip this dose.
Rivaroxaban if this is just a single dose taken in the morning, we can move this dose to the evening after the extraction. If it is two doses (one in the morning and one in the evening) it is recommended that you stop the dose in the morning and continue as normal with the evening dose. If it is only an evening dose, then there is no need to change the regime prior to your extraction.
If you would like more details check out this website - https://www.sdcep.org.uk/published-guidance/anticoagulants-and-antiplatelets
If you have any medical condition such as the history of endocarditis, or you have had replacement heart valves, kindly speak to your cardiologist and if you have been advised that you will need an antibiotic cover for the extractions please let us know and we would be happy to prescribe the antibiotic cover for the same after consultation with your Cardiologist. Find all details https://www.sdcep.org.uk/wp-content/uploads/2018/08/SDCEP-Antibiotic-Prophylaxis-Patient-Information.pdf
It is best to have a restful rest of the day. It is important not to take part in any activity that can induce more pumping of the blood like heavy exercises such as running or the gym. It is also very important to avoid any swimming for the rest of the following 24 hours after the extraction.
If you are very nervous, you can have a painkiller, such as ibuprofen(if it is safe to do so), 1 hour before the procedure which can take away some of the pain from the injection site, although we do practice all techniques to ensure the injection is as minimally painful as can be.
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