Heart Disease, Blood Thinners and Tooth Extraction
The right question is not whether to stop the drug but how to manage the bleeding.
Why stopping the drug is not the first choice
Blood thinners are not prescribed lightly; they prevent clots and the serious events that follow them, and stopping the drug for a few days removes that protection. Bleeding after an extraction, by contrast, happens in a visible site that can be treated directly. Current practice is therefore to continue the medication for single extractions and similar limited procedures and to manage bleeding locally. The dentist does not decide alone; the prescriber is consulted where needed. What the patient must do is not stop the drug but report every medicine and cardiac condition before the appointment.
What to report before the appointment
- The name and dose of every medicine you take
- Your recent INR value if you take warfarin
- Any prosthetic heart valve or previous endocarditis
- Previous heart attack, stent or bypass surgery
- A pacemaker or similar implanted device
- Uncontrolled hypertension or an arrhythmia
- Any previous experience of prolonged bleeding
Managing bleeding during and after the procedure
Bleeding is limited by working as atraumatically as possible, placing resorbable haemostatic material in the socket, suturing where needed and rinsing with a tranexamic acid mouthwash. Morning and weekday appointments are preferred so help is easy to reach the same day. Afterwards the patient bites firmly on gauze for about half an hour without interruption, and avoids spitting, straws, smoking and hot drinks that day, all of which keep the clot in place. A slight ooze for a few hours is normal; bleeding that does not stop with pressure is not.
Getting Here, Booking and Emergencies from Varsak Menderes
Route, booking and emergency arrangements for patients from Varsak Menderes.
Getting here from Varsak Menderes
Varsak Menderes lies in the Kepez district of Antalya; Kepez is one of the central districts, about 6 kilometres from the clinic. We also see patients from neighbouring areas that share the route from Varsak Menderes, such as Yeni Doğan, Ahatlı, Avni Tolunay, Çamlıbel. You can ask for the location on WhatsApp when travelling from Varsak Menderes.
Appointments for Varsak Menderes
At this distance, splitting treatment into visits is no problem for patients from Varsak Menderes, and attending reviews is easy too. As with patients from Kepez generally, appointments for families from Varsak Menderes can be scheduled consecutively.
Emergencies from Varsak Menderes
Setting out from Varsak Menderes at night is quick; come without delay in an emergency, and calling as you leave means preparation is done in advance. For patients coming from Dental Clinic in Varsak Menderes, the clinic is open 24/7 and in an emergency the order is set by severity rather than arrival time. For spreading facial swelling, difficulty swallowing or breathing, or toothache with fever, go to the nearest emergency department.
The Smile Line: Limits Set by the Lip
Identical teeth in two people still produce different smiles, because how far the lip rises and how many teeth show is individual. An aesthetic plan begins with that measurement.
Three smile types
The classification directly determines the scope of treatment:
- Low smile: part of the upper teeth shows and no gum is visible
- Average smile: the full teeth and 1 to 2 mm of gum show
- High smile: 3 mm or more of gum shows
- In a low smile the gum level is hardly ever an issue
- In a high smile the gum line matters as much as the teeth
Why the plan changes accordingly
In a patient with a low smile line, small irregularities in gum level are invisible anyway, so gum surgery is unnecessary and would be an operation for nothing. In a high smile the same irregularity is immediately obvious and spoils the result however good the crowns are. The same procedure in the same mouth becomes necessary or unnecessary depending on the smile line.
How it is measured
Not with a forced smile but by capturing the natural one. Photographs are therefore not enough and video is recorded: lip movement is observed while the patient speaks and smiles. How much of the front teeth shows at rest is also measured — that amount decreases with age, and tooth length is planned accordingly.

































































