Dear Dr. Rotar,
I am a heart patient and because of an irregular heartbeat (atrial fibrillation) I take Marivarin. In addition, I have had dental problems for a long time. My dentist suggested extracting my lower first molar several years ago, but I did not have it done then. Now the tooth is causing me increasing problems. Can you extract this tooth despite Marivarin?

If the reasons for extracting the tooth are obvious, then of course it needs to be removed. Marivarin in principle does not represent a major obstacle to an oral-surgical procedure. Patients usually stop taking Marivarin five days before the procedure and start taking it again the day after the procedure. Of course, the patient's health status must make such interruption acceptable. If stopping the medication is not acceptable because of an increased risk of worsening the condition, professional doctrine allows procedures at quite high INR values (up to 2.3). Because of this, the surgical wound receives special treatment after the procedure (the wound is sutured, and substances for faster hemostasis are placed in the alveolus). Taking Marivarin must not be a reason to postpone an urgent procedure.

Be brave!