Can I have dental surgery if I take blood thinners or osteoporosis medication?

Why these medications matter for extractions and implants, and how treatment is planned around them.

Dr Bill Kalis — Saturday 14 November 2026

Usually, yes. Most people who take blood thinners or osteoporosis medication can still have extractions, implants and other dental surgery. It needs planning, so tell us about these medications before any treatment is booked, and do not stop them on your own.

I am Dr Bill Kalis, principal dentist at Padstow Dental in Padstow, Sydney. I ask every surgical patient about these two groups of medication.

Which blood thinners matter?

Tell us if you take any of these:

• Warfarin

• Apixaban (Eliquis), rivaroxaban (Xarelto) or dabigatran (Pradaxa)

• Clopidogrel (Plavix), ticagrelor or prasugrel

• Aspirin

• Fish oil, turmeric, ginkgo or other supplements, which can also affect bleeding

Should I stop my blood thinner before dental surgery?

Do not stop it yourself. These medications protect you from stroke, heart attack and clots, and stopping them can be more dangerous than the bleeding they cause. For many dental procedures they are continued, and bleeding is managed locally. Where a change is being considered, I speak with your doctor or specialist first.

How is bleeding managed?

• Planning the procedure for earlier in the day and earlier in the week

• A recent blood test if you take warfarin

• Careful technique, stitches and dressings that help a clot form

• Clear instructions on what to do at home, and who to call

Which osteoporosis medications matter?

Tell us if you take, or have ever taken:

• Tablets such as alendronate (Fosamax) or risedronate (Actonel)

• Injections such as denosumab (Prolia)

• Infusions such as zoledronic acid (Aclasta)

• Similar medications given as part of cancer treatment

Why do osteoporosis medications matter?

These medications change the way bone heals. Rarely, after an extraction or other surgery involving the jawbone, the bone does not heal properly. This is called medication-related osteonecrosis of the jaw. The risk is low for most people taking these medications for osteoporosis, and higher with the doses used in cancer treatment.

Can I still have an extraction or an implant?

In most cases, yes. We consider which medication you take, how long you have taken it and your general health, and we may contact your doctor. For some medications the timing of surgery matters. Do not stop or delay a dose on your own.

What is the best time to see a dentist?

Before you start an osteoporosis medication, if you can. Having a check-up and any extractions done first reduces the need for surgery later. If you are already taking one, regular check-ups and good daily cleaning help you avoid extractions.

Common questions about medications and dental surgery

Do I need a letter from my doctor?

Not always. Bring a current medication list, and we contact your doctor if needed.

Does this apply to fillings and cleans?

Fillings are not affected. Tell your clinician before a clean if you take a blood thinner, as gums may bleed more.

Can I have IV sedation?

Often, yes. The sedationist reviews your medical history first.

What if I have been on osteoporosis tablets for many years?

Tell us how long. It is part of how we plan.

Planning dental surgery?

Call Padstow Dental on 02 9773 4775. This article is general information and does not replace advice from your own doctor and dentist.

Any surgical or invasive procedure carries risks. Before proceeding, you should seek a second opinion from an appropriately qualified health practitioner.

Written by Dr Bill Kalis, Principal Dentist at Padstow Dental. BDS (Hons), University of Sydney, 1994. Graduate Certificate in Clinical Dentistry, University of Adelaide, 2007. Past State and Federal President of the Australian Society of Implant Dentistry. Dr Kalis is a general dentist with a focus on implant, surgical and IV sedation dentistry.