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Certified Lab

Our certified doctors and assistants have the ability to give INR (Coumadin) and Glucose Level testing in our office

INR testing for patients taking the anticoagulation medication Coumadin.

International Normalized Ratio or INR, is the standard unit for reporting the clotting time of blood, and it must be tested frequently in order for a person on anticoagulation medication to stay in his or her prescribed "range" to avoid dangerous complications, including blood clots, hemorrhage or stroke. Our doctors can administer this blood test at our office during your visit in order to evaluate current blood clotting levels of each patient.

Anticoagulant Medications

Warfarin (or Coumadin®) is an anticoagulant medication that slows blood from clotting. It does this by preventing some of the clotting factors in the liver from being formed. You may hear that warfarin "thins" the blood. Technically speaking, the blood is not "thinner," it just takes longer to clot.

Staying in this therapeutic range is very important to avoid serious complications

Each individual needs a different dose of warfarin (coumadin), and it is difficult to predict how much will be needed. Warfarin can also interact with other medications/supplements, as well as chemicals that can be present in some foods. This is true in particular with Vitamin K, which is often found in large amounts in green, leafy vegetables and pistachio nuts. For these reasons and others, it is necessary and important to frequently monitor the blood so that the warfarin dosage can be adjusted prior to your surgery, if required.

What is INR and why is it important?

Monitoring is usually done by checking a person’s INR. INR is the standard unit for reporting the clotting time of blood. A common target INR level for a person taking anticoagulants is 2.0 to 3.0, though it can vary from one individual to another, and should be determined by a physician. In general, the higher the number, the longer it takes the blood to clot. The target set by a physician for an individual patient is also called the therapeutic INR range, and is dependent upon the condition being treated and the risk of clot formation. However, no matter what range is prescribed, staying in this range is very important to avoid serious complications, including stroke, blood clots and hemorrhaging.

The anticoagulant dosage, determined by the doctor, may also vary over time. Maintaining the proper range is difficult for some patients, since many factors can cause levels to quickly rise or fall. Frequent and consistent testing is required in order to make proper adjustments to maintain the effectiveness of the medication, which helps to prevent serious side effects. While the typical patient has their INR tested every four to six weeks at a clinic, studies now show that more frequent testing significantly reduces complications by helping to keep patients in range.

A current INR test is especially important prior to any oral & maxillofacial surgery procedure as it will let the surgeon know how likely you are to have bleeding complications at your current level.

Glucose Level Testing

It is important for our surgeons to know that your diabetes is under good control especially when undergoing intravenous sedation. This is especially important in Type I Diabetes Mellitus. As a person with diabetes you know that your blood sugar changes literally by the minute. And even though you checked it in the morning prior to your surgery your doctor may wish to check it again immediately prior to you sedation surgery. Some people are now wearing CGM’s (continuous glucose monitors) and these are very helpful, and can tell not only glucose trends but also glucose levels. However, even these high tech monitors need to be checked against the patient’s real blood level.

Infections are also important from the standpoint of good blood glucose control. If you are unfortunate enough to have a dental abscess you will need to be vigilant in checking your blood glucose levels. Infections of any sort will tend to cause blood sugars to be higher, similar to when you get sick. Once your health is restored you should expect your blood sugars to return to their more normal readings.