Medications and Implant Surgery: What to Disclose to Your Surgeon

Why Full Disclosure Matters

Your surgeon needs complete medication information to:

• Assess bleeding risk
• Prevent complications
• Plan medication adjustments safely
• Coordinate with your physician
• Ensure safe anesthesia

Never hide medications or supplements - be completely honest.

Critical Medications to Disclose

Medication Category	Concern	Management
Anticoagulants (Warfarin, DOACs like Apixaban/Rivaroxaban)	Increased bleeding	May need bridging/adjustment - coordinate with prescribing doctor
Antiplatelets (Aspirin, Clopidogrel)	Bleeding risk	Often continued for low-risk procedures, but need assessment
Bisphosphonates (Oral/IV - Alendronate, Zoledronic acid)	Osteonecrosis of jaw risk (rare but serious)	Critical to disclose; may need special protocols
Denosumab (Prolia)	Similar concerns to bisphosphonates	Must disclose, affects treatment planning
Immunosuppressants	Infection/healing risk	May need antibiotic prophylaxis
Corticosteroids (long-term)	Delayed healing, infection risk	May need stress dosing considerations
Diabetes medications	Blood sugar control during surgery	Timing adjustments may be needed
Chemotherapy agents	Complex - timing critical	Often need oncologist coordination

Supplements & OTC to Disclose

Many people forget these:

• Fish oil/Omega-3 - can increase bleeding
• Vitamin E - blood thinning effects
• Ginkgo Biloba - bleeding risk
• Garlic supplements - can affect clotting
• Ginseng - various interactions
• St. John’s Wort - drug interactions
• Herbal supplements - often not disclosed but matter

What To Bring

• Complete medication list - Name, dose, frequency, reason
• Prescriptions - Bring bottles or pharmacy list
• Over-the-counter - Include everything
• Supplements/herbals - All of them
• Recent lab work - If available
• Physician contact - For complex cases

Important Rules

1. Don’t stop medications yourself - Always coordinate with prescribing doctor
2. Disclose everything - Better to over-disclose than miss something
3. Do this in advance - At least 1-2 weeks before surgery for complex cases
4. Ask about coordination - Surgeon should work with your other doctors
5. Follow instructions - Exactly as given

Special Considerations

Blood Thinners

• Never stop abruptly without medical guidance
• Risk vs benefit assessed by your cardiologist/physician
• Some procedures need temporary changes, others don’t
• Local hemostasis techniques used when continuing

Bisphosphonates

• Duration matters - Longer use increases risk
• IV bisphosphonates higher risk than oral
• “Drug holiday” controversial - not always recommended
• Specialist management often needed

Diabetes

• Good control is key - HbA1c ideally <7-8%
• Morning surgery preferred - Easier blood sugar management
• May need meal/medication timing adjustments

Questions to Ask

• Do I need to adjust any medications? Which ones?
• Do I need medical clearance? From whom?
• Should I take my morning medications? Specific instructions
• Do I need antibiotic prophylaxis? Based on conditions
• When can I restart medications? Post-op instructions

Bottom Line

Complete disclosure is non-negotiable for safe surgery. Your surgeon isn’t judging - they need this information to keep you safe. Coordinate with all your doctors well in advance, especially for complex medication regimens.

Related Resources

• Dental Implants for Seniors: Age Myths and Health Considerations
• Sinus Lift and Bone Grafting Abroad: Why Surgeon Choice Matters
• Flying After Dental Implant or Sinus Lift Surgery: What to Ask Your Surgeon