I would consult with the Patients cardiologist. I would not recommend removing the coumadin as long as he is held around 3.0. There are plenty of papers on this subject.

J Oral Maxillofac Surg. 2007 Aug;65(8):1454-60.

Dentoalveolar procedures for the anticoagulated patient: literature recommendations versus current practice.
Ward BB, Smith MH.

Department of Surgery, Section of Oral and Maxillofacial Surgery, University of Michigan, Ann Arbor, MI 48109, USA. bward@umich.edu

PURPOSE: To evaluate the current practice of oral and maxillofacial surgeons in Michigan regarding perioperative warfarin therapy and dentoalveolar surgery in defined procedure risk groups. MATERIALS AND METHODS: Surveys were distributed to all surgeons (n = 188) registered with the Michigan Society of Oral and Maxillofacial Surgeons. Low/moderate/high surgery risk groups were defined based on retrospective data accumulated for procedures on pretransplant liver failure patients. We requested the surgeon's maximum tolerated International Normalized Ratio (INR) for each risk group. In addition, surgeons were asked if their routine practice for each group included continuation or discontinuation of therapeutic warfarin perioperatively. RESULTS: A 72.6% response rate was achieved. The average maximum INR cutoff values for the various risk groups were: low, 2.68; moderate, 2.28; and high, 2.01. Routine discontinuation of warfarin occurred in these groups 23.6%, 48.8%, and 70.5%, respectively. Using a paired t test, these results showed statistically significant differences in patient management practices (P < .001) between the low, moderate, and high risk groupings. CONCLUSION: Lack of uniformity exists regarding warfarin therapy and dentoalveolar surgery. No studies to date involve significant numbers of moderate/high risk procedures to provide evidence-based support of safety with maintenance of therapeutic INR. For moderate or high risk procedures, the majority of surgeons prefer warfarin discontinuation with minimally therapeutic or subtherapeutic levels, a practice that secondarily increases risk for thromboembolism. Based on these preliminary data, we believe a prospective trial to elucidate stronger management guidelines for both the moderate and high risk surgery population is indicated.

Current concepts of the management of dental extractions for patients taking warfarin.
Carter G, Goss AN, Lloyd J, Tocchetti R.

Oral and Maxillofacial Surgery Unit, Royal Adelaide Hospital, Adelaide Dental Hospital and The University of Adelaide, South Australia.

Comment in:

Aust Dent J. 2003 Dec;48(4):267-8; author reply 268.

BACKGROUND: Controversy has surrounded the correct management of patients therapeutically anticoagulated with warfarin who require dental extractions. The risk of bleeding must be weighed up against the risk of thromboembolism when deciding whether to interfere with a patient's warfarin regimen. An improved understanding of the importance of fibrinolytic mechanisms in the oral cavity has resulted in the development of various local measures to enable these patients to be treated on an outpatient basis. METHODS: A review of the literature was undertaken. This was supplemented by the authors' clinical trials and extensive clinical experience with anticoagulated patients. RESULTS: Various protocols for treating patients taking warfarin have been reviewed and summarized and an overview of the haemostatic and fibrinolytic systems is presented. A protocol for management of warfarinized patients requiring dental extractions in the outpatient setting is proposed. CONCLUSIONS: Patients therapeutically anticoagulated with warfarin can be treated on an ambulatory basis, without interruption of their warfarin regimen provided appropriate local measures are used.