Living with a Mechanical Heart Valve: Click.Tick.Thump. Love It!

Support Group for Mechanical & Artificial Heart Valve Surgery & Using Warfarin

This is now the 2nd infection of a root canal filling (5 years old & covered by a crown).  I am currently taking amoxicillin but the infection is not clearing.  My dentist has said that the only thing to do now is an extraction.  I asked about an implant but he felt this was risky on warfarin.

The tooth is on the upper jaw and 3rd tooth along from the back so I guess a gap is not too bad.

I intend taking 2g of amoxicillin 1 hour before the extraction as advised by my surgeon and I've been told by the warfarin clinic that my INR must be below 4.  Wondered if anyone has had a tooth extraction & if there is any other advice I should follow e.g. should I take a course of antibiotics after the extraction? How was the clotting process following extraction? 

Dental work has never much bothered me but now I have a mechanical mitral valve and am on warfarin, I'm concerned about bacterial endocarditis. 

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Sorry to hear about the tooth infection, I had the same but luckily the amoxicillin worked.


My dentisit will not even do a check-up if my INR is over 3, and I would have thought 4 would be a bit high for an extraction, you might want to discuss this with your GP or Anti-colagulate clinic.


As far as antibiotics are concerned as I understand the British Dental Association has changed its recommendation on this.  My dentist no longer requires antibiotic cover for normal dental work (I have not had an extration since I have been on warfarin) - this was agreed by my GP.  See however if in doubt I would certainty take antibiotics!


Good luck



I had a one taken out a couple of months ago, my INR had to be below 3, I took the amoxicillin, no issues with bleeding etc it healed up as per normal and the gap is minimal - hope this helps.

Thanks for the reassurance James and Mark.  I wish there was more consistency between dentists, Cardio Teams, GP's & Warfarin Clinics.



had a tooth out 2 years ago and same procedure as you describe. I think however I had 5g amoxicillin (??) My dentist however won't touch my mouth for any other procedure (fillings etc) unless my INR is 3 or below within 24 hours of the INR test which I have to produce evidence of. Also now don't need antibis for this work (fillings etc) as James has said. Only for tooth extraction I think.  Did not take any antibiotics after my tooth extraction and clotting was fine.  

hope this helps



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