<s>[INST] I am curious my husband has been on lovenox 2x/day for about 4 yrs now. He has Antiphospholipid syndrome. He has a broken tooth that needs pulled we have always been told not to have extractions while on lovenox. Now we are told it is perfectly find to have the tooth pulled with out any modifications to his lovenox. What has changed in the past several years that it is ok to do now? I am very confused 2 mo ago the rhuematologist said dont let them pull it while he is on lovenox he will bleed to death. Yesterday he says no it ok go ahead. Please help [/INST] hi, we understand your problem. Lovenox is a low molecular weight heparin drug which increases the chances of bleeding if any surgical procedure like extraction of tooth is undertaken during its ongoing therapy. But this bleeding can easily be controlled by a dentist by local measures and extraction of tooth can be carried out safely. Nothing has changed in the drug per se, only the concepts of managing the patients on such drugs has evolved. Dont worry and get the treatment done for your husband. my suggestion would be to get it treated by an oral surgeon who are used to handle such cases on regular basis. thank you </s>