Patients with coronary stents who are taking anticoagulants can safely undergo tooth extraction if their cardiovascular health is stable and a doctor manages potential complication risks.

Typically, invasive dental procedures are advised to be delayed for the first 6 months after stent placement, as this is a sensitive period when the vessel lumen is not yet stable. Since your stent was placed one year ago, you have passed this critical phase and can proceed with tooth extraction.

Before tooth extraction, you should visit a general hospital with integrated dental and cardiology departments for an examination and screening tests. Bring your complete medical records, including current medication prescriptions, discharge papers, or information related to the type of stent placed, for doctors to assess your condition. Do not stop or alter the dosage of your cardiac or antiplatelet medications without a doctor's explicit instruction.

The primary risk in this situation is prolonged bleeding after tooth extraction due to the effects of anticoagulants. However, if patients stop their medication without medical advice, blood clots can easily form, obstructing the stent and potentially leading to an acute myocardial infarction. Furthermore, anxiety and pain during dental work can elevate blood pressure and heart rate, placing strain on the coronary system.

Modern technology has made dental treatment for cardiac patients safer and more effective. Many hospitals now employ ultrasound wave tooth extraction techniques, using ultrasound vibrations to separate the tooth root from its ligaments with minimal impact on surrounding soft tissues and blood vessels. This minimally invasive method reduces bleeding and swelling, shortens procedure time, and limits the risk of cardiovascular complications.

Dr. Thu (right) performs tooth extraction using ultrasound technology on a patient. Illustration: Tam Anh General Hospital

After tooth removal, doctors place a resorbable hemostatic material into the tooth socket, then suture the overlying gum tissue to secure the material internally and hold the blood clot in place, preventing recurrent bleeding. In some cases, patients are advised to use mouthwash containing coagulating agents to stabilize the wound before discharge.

Following the procedure, you must closely monitor the extraction site. If bleeding does not stop after 30-60 minutes of biting on gauze, immediately inform your doctor for prompt management. You should also adhere to any prescribed antibiotics to prevent infective endocarditis—a condition where bacteria enter the bloodstream, causing a heart valve infection, which is dangerous for individuals with cardiovascular disease.

Dr. Duong Anh Thu, Specialist Doctor Level I

Head of Dental and Maxillofacial Unit

Tam Anh General Clinic, District 7