Dental Implants For Heart Patıents And Those On Blood Thınners

Dental Implants for Heart Patients and Those on Blood Thinners

Is it Possible, Is it Safe?

You have heart disease or have been taking blood-thinning medication for a long time, and you want to get a dental implant…
You probably have these questions in mind:

• "Doctor, I have a heart condition, can I get an implant?"

• "I've had a stent placed, I've had bypass surgery, is it risky?"

• "I'm on blood thinners, won't my bleeding stop?"

The good news is:
Today, many heart patients and people using blood thinners can undergo implant treatment with proper planning.
However, it's not as simple as "Come on, let's do it"; there are important points that need attention.

In this article, we will explain implant treatment for heart patients and those on blood thinners in a language everyone can understand.

What is Heart Disease, What Does it Include?

Someone who says "I have heart disease" could actually be referring to many different conditions:

• Coronary artery blockage (atherosclerosis)

• History of heart attack

• Stent placement

• Bypass surgery

• Heart valve diseases

• Rhythm disorders (arrhythmias)

• Heart failure

Not all of these conditions carry the same level of risk.
Therefore, when deciding on an implant, your dentist will usually ask detailed questions like:

• "What specific heart condition do you have?"

• "When were you diagnosed, when did you have surgery?"

• "What medications are you currently taking?"

The goal is to create a safe treatment plan for you.

Why Are Blood Thinning Medications Used?

Some medications commonly used in heart and vascular diseases include:

• Aspirin (acetylsalicylic acid)

• Anti-platelet drugs like clopidogrel, prasugrel, ticagrelor

• Classic blood thinners like warfarin

• Some new generation oral anticoagulants (NOACs)

The purpose of these medications is to:

• Prevent blood clot formation,

• Prevent stents from clogging,

• Reduce the risk of serious events like heart attack and stroke.

In other words, these medications are vitally important for you.
Therefore, stopping these medications on your own accord just because you're having a tooth extraction or implant is extremely dangerous.

Can Implants Be Placed in Heart Patients and Those on Blood Thinners?

The short answer:
Yes, in the vast majority of cases, it can be done.

But for this, the following are necessary:

• Your heart disease being stable,

• Your cardiologist's approval,

• Special planning according to the blood thinner used.

In high-risk periods such as a recently suffered heart attack, a very new stent, or uncontrolled arrhythmia, most often all elective procedures, including implants, are postponed.

The most important thing at this point is:

Your dentist and your cardiologist being aware of each other and planning together.

Which Doctors Should You Talk to Before an Implant?

If you have heart disease, before implant planning:

• It is very important to go to your cardiologist and explain the situation.
  – "My dentist is planning an implant, is there any contraindication for this procedure?"
  – "Does my blood thinner medication need adjustment?"
  You need to get answers to such questions.

In some cases, your internist or family doctor may also be involved in the process.
Your dentist may request a written consultation from your cardiologist. This is a safety shield for you.

Should Blood Thinning Medications Be Stopped or Reduced?

This is one of the most critical questions, and the answer is absolutely specific to the individual.

The general principle is:

• For simple tooth extractions and minor surgeries,
  most of the time, the procedure can be performed without completely stopping blood thinners,
  using local measures (sutures, tamponade, hemostatic agents).

• For implant surgery and larger procedures,
  considering your cardiovascular risk and the type of medication you use,
  – sometimes dose reduction,
  – sometimes a short-term break,
  – sometimes leaving it untouched may be preferred.

This decision should be made:

• Not by your dentist alone,

• But together with your cardiologist.

Remember:

The approach of "Let my bleeding be a bit more, as long as my heart problem doesn't recur"
is often safer.

Because an uncontrollable bleeding can be managed in the clinic;
but a stent blockage or a serious clot complication can be life-threatening.

How is Implant Surgery Planned for Heart Patients and Those on Blood Thinners?

Several special measures can be taken for you:

• Shorter and controlled sessions:
  – Instead of many implants in one day,
  – A fewer number of implants can be planned.

• Stress management:
  – Appointment time,
  – Waiting period,
  – If necessary, with mild sedative support,
  efforts are made to reduce stress on the heart.

• Local bleeding control:
  – Good suturing technique,
  – Hemostatic sponges or agents,
  – Applying correct pressure to the area after the procedure
  are among the measures used.

• Follow-up:
  – In the first hours and first day after the procedure,
  – Your doctor will be in contact with you for monitoring.
  – Additional dressing and intervention can be done if necessary.

Heart Valve Disease and Infective Endocarditis Risk

In some heart patients, especially:

• Those with artificial heart valves,

• Those in the risk group due to valve disease,
  the risk of heart infection (infective endocarditis) may increase after dental and gum-related procedures.

Therefore, in this group:

• Before certain dental procedures, including implants,

• Prophylactic antibiotics may be started as recommended by the cardiologist.

This decision must also be made through communication between your cardiologist and your dentist.
It is not correct to take antibiotics on your own.

What Should You Pay Attention to in the Post-Implant Period?

If you have heart disease and are on blood thinners, in the post-implant period:

• Use the painkillers and antibiotics prescribed by your doctor regularly.
  – Some painkillers are not preferred for heart patients; your doctor makes a special selection on this matter.

• For bleeding control:
  – Apply pressure to the given tampon for the specified duration in the first hours.
  – Spitting, vigorous rinsing, consuming hot drinks/food can increase bleeding; avoid these.

• Pay attention to oral hygiene:
  – If there are cavities and gum problems, the risk of infection increases.
  – Clean the implant area as instructed by your doctor.

• If you notice any:
  – Prolonged and unstoppable bleeding,
  – Increasing pain and swelling,
  – Systemic