Apixaban and Dental Procedures: What You Need to Know

When you're taking Apixaban, a direct oral anticoagulant used to prevent blood clots in people with atrial fibrillation, deep vein thrombosis, or after hip or knee replacement surgery. Also known as Eliquis, it works by blocking Factor Xa to keep your blood from clotting too easily. This is great for reducing stroke risk—but it changes how your body handles even small cuts, like those from a dental cleaning or tooth extraction.

Many people assume they need to stop Apixaban before any dental work, but that’s not always true. The American Dental Association and major cardiology groups agree: for most routine procedures—cleanings, fillings, simple extractions—you should keep taking it. Stopping increases your risk of a clot more than the small chance of extra bleeding. Dental procedures, including tooth extractions, root canals, and gum surgery can cause bleeding, but dentists know how to manage it with local pressure, sutures, or hemostatic agents. You don’t need to skip your cleaning or delay needed work just because you’re on a blood thinner.

What you do need to tell your dentist: your exact dose of Apixaban, when you last took it, and if you’ve had any unexplained bruising or bleeding lately. If you’re having a complex surgery—like multiple extractions or bone grafting—your doctor and dentist might coordinate to adjust timing, but rarely stop the drug entirely. Blood thinners, including Apixaban, rivaroxaban, and dabigatran all carry similar risks, and dental teams are trained to handle them. Don’t assume your dentist knows you’re on Apixaban—always speak up. A quick note in your chart can prevent panic during a procedure.

Some patients worry about swelling or prolonged bleeding after a tooth is pulled. That’s normal. You’ll likely have some oozing for 24 hours. Bite down on gauze, avoid spitting or rinsing hard, skip straws, and don’t smoke. Ice packs help. If bleeding soaks through two gauze pads in an hour, call your dentist. Most cases are easily fixed with a quick visit. Anticoagulant safety, the practice of managing medications like Apixaban during medical or dental interventions is now standard in clinics. It’s not about avoiding care—it’s about planning it right.

There’s no one-size-fits-all rule. If you’ve had a recent clot, a mechanical heart valve, or kidney issues, your situation might need extra care. But for most people, the safest move is to keep taking Apixaban and let your dental team handle the rest. You don’t have to choose between protecting your heart and your teeth. With the right info and communication, you can do both safely.

Below, you’ll find real-world advice from patients and providers who’ve navigated dental work while on Apixaban—what worked, what didn’t, and how to avoid common mistakes. No fluff. Just what you need to know before your next appointment.