Diabetes in dentistry
Consider glycaemic control, meal and medication timing, hypoglycaemia risk, infection and wound healing. Coordinate changes for complex cases.
Understand
Diabetes affects infection, periodontal inflammation and healing; treatment itself may provoke hypoglycaemia if food and medicines are mismatched. HbA1c gives longer-term context, not a real-time glucose level.
Assess
Ask about type, treatment, recent control, hypoglycaemia awareness, meals and acute illness. Consider the timing and length of the appointment and extent of infection.
Apply
Plan food and medication around care with the appropriate medical team for complex cases. Treat urgent infection promptly and be prepared to recognise and manage hypoglycaemia.
Key distinctions
Diabetes can alter immune response and healing, but most routine dental decisions depend on current clinical state as well as longer-term control. An HbA1c does not tell you whether a patient is hypoglycaemic now. Longer procedures, fasting and acute infection can disrupt usual meals and medication. Plan a safe appointment and coordinate with medical care when needed.
Think through a case
A patient on insulin arrives for a long morning appointment without breakfast. Check their immediate status and adapt the plan rather than relying on last month's HbA1c.
The distinction to remember
Do not confuse chronic glycaemic assessment with real-time hypoglycaemia risk at the chair.
Test your recall
What immediate risk rises when a fasting patient takes glucose-lowering medication?
Show answer
Hypoglycaemia.