Blood Thinners & Dental Procedures

Sleep Apnea

Obstructive Sleep Apnea

Your sleep impacts every aspect of your health and daily life. Sleeping well helps you look, feel and perform your best. But a sleep problem can be harmful to your health and well-being. One of the most common sleep problems is obstructive sleep apnea. Learn more about the warning signs and how you can get help.

About Obstructive Sleep Apnea

Nearly 30 million adults in the U.S. have obstructive sleep apnea (OSA), which can cause them to stop breathing hundreds of times a night for anywhere from a few seconds to more than a minute.

Sleep apnea is a chronic condition that occurs when your muscles relax during sleep, allowing soft tissue to collapse and block the airway. As a result, repeated breathing pauses occur, which often reduce your oxygen levels. These breathing pauses are followed by brief awakenings that disturb your sleep.

Common signs of sleep apnea include snoring and gasping or choking sounds during sleep. Like snoring, sleep apnea is more common in men, but it can occur in women too, especially during and after menopause. Having excess body weight, a narrow airway or misaligned jaw all increase the risk of sleep apnea.

Is Treating OSA Important?
Treating obstructive sleep apnea is incredibly important to your health. When left untreated, sleep apnea often causes excessive daytime sleepiness or fatigue, as well as morning headaches and memory loss. Sleep apnea also is a threat to your safety as it increases your risk of drowsy driving and workplace accidents. Untreated sleep apnea raises your risk for serious health problems. These include:

  • High blood pressure
  • Stroke
  • Heart disease
  • Diabetes
  • Chronic acid reflux
  • Erectile dysfunction

Severe, untreated sleep apnea even increases your risk of death.

How is OSA Diagnosed?
Kleinheinz Dentistry is proud to offer a Free Sleep Study. Call our office for more information. 704-542-6003.

How is OSA Treated?

Dr. Kleinheinz can discuss treatment options with you. We will provide a FREE SLEEP STUDY at your convenience.

  • Oral appliance therapy uses a mouth guard-like device - worn only during sleep - to maintain an open, unobstructed airway.

Research shows that oral appliance therapy is an effective treatment option for snoring and obstructive sleep apnea. An oral appliance is worn in the mouth only while you sleep and fits like a sports mouth guard or an orthodontic retainer. Oral appliances support your jaw in a forward position to help maintain an open upper airway.

Many patients consider a sleep apnea appliance to be more comfortable to wear than a CPAP mask. Oral appliances also are quiet, portable and easy to care for.

If you decide that oral appliance therapy is the best treatment option for you, then Dr. Kleinheinz will recommend a prescription for you to receive a custom-made sleep apnea appliance. More than 100 oral appliances have received FDA clearance. We prescribe and make the FDA approved appliances. Oral appliance therapy is covered by many medical insurance plans. We will do a complete benefits check upon your scheduled appointment.

Blood thinners.Millions of people regularly take anticoagulant or antiplatelet medications (sometimes called “blood thinners”) to help prevent heart attack and stroke, and to manage a variety of medical conditions including cardiac arrhythmia and stent placement. While these drugs have proven, life-saving benefits, they can also cause side effects such as increased bleeding. So it may be a cause for concern if you're taking one of them and you need to have a dental procedure.

Anticoagulants are among the more widely used pharmaceuticals today, particularly for heart patients. Some common prescription anticoagulants include heparin, warfarin (Coumadin and generics), clopidogrel (Plavix) and dabigatran etexilate (Pradaxa). Regular aspirin and NSAIDS (like Advil) also have anticoagulant properties. The purpose of anticoagulant medications is to keep the blood from clotting (clumping together) as readily as it normally does; this reduces the chance of a clot forming inside a blood vessel, which could lead to a stroke or heart attack.

If you are taking one or more of these medications, it will take longer for any type of bleeding to stop. For some dental or surgical procedures, that's a factor that must be considered. The most important thing you should do is inform your dentist right away if you are taking any kind of anticoagulant or antiplatelet medication — especially if you have just started taking it. The name and dosage of your medication will be noted in your records, and your cardiologist (or other specialist) will be consulted if necessary, to determine what's best for you.

Having Dental Work with Blood Thinners

While each patient is different, there are some generally accepted guidelines for having dental work while taking anticoagulant medications. If the drug is being taken on a temporary basis (after knee replacement, for example) then the safest choice might be to put off non-essential dental procedures. However, in many cases it's entirely possible to have needed work done while taking anticoagulants. In each situation, the risk of increased bleeding must be balanced against the chance that going off the medication could cause more serious problems.

A number of studies have shown that for many common dental procedures — cleanings, fillings and restorations, for example — it's safer to continue taking anticoagulant medications than to stop, even temporarily. That's because it is generally possible to control bleeding with local measures (such as biting down on gauze), using hemostatic devices and minimally invasive surgical techniques. Scheduling dental work for early in the day and allowing plenty of time for rest afterwards also provides an opportunity to control any bleeding that does occur.

More Complex Procedures

In some cases, more extensive dental procedures such as tooth extraction or implant placement may be recommended for people taking anticoagulants. As always, the potential risks and benefits of stopping the anticoagulant medication must be carefully weighed. To help in the decision-making process, one or more diagnostic blood tests, such as prothrombin time (PT) or International Normalized Ratio (INR), may be ordered. Then a judgment can be made, based on the test results and on clinical experience.

While it's extremely rare for common dental procedures to cause potentially life-threatening complications, it makes sense to take as few chances as possible. That's why you should tell us about any medications you may be taking, including herbs and vitamins. While taking anticoagulants doesn't prevent you from having dental work, it's important to share information about your medications so you can get the best results from your treatment.

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