Medical Emergencies · single question
A diabetic patient (HbA1c = 9) presents with a tooth in spontaneous, lingering pain. What is the most appropriate management?
Show answer and explanation
Correct answer: D. Treat the dental emergency first, then refer to physician for diabetes management
D) Treat the dental emergency first, then refer to physician — CORRECT.
An HbA1c of 9% indicates poorly controlled diabetes (normal < 5.7%, poorly controlled > 8%). The patient has acute dental pain (irreversible pulpitis or necrosis). The standard of care is to treat the acute dental emergency (provide pain relief, begin endodontic treatment or extraction) and simultaneously refer the patient to their physician for better glycemic control.
A) Referring without treating leaves the patient in pain and active infection, which will further elevate blood glucose.
B) ER referral is appropriate only for severe systemic complications — not routine endodontic emergencies.
C) Calcium hydroxide temporarily is not the primary emergency treatment; the focus should be emergency pulp treatment.
An HbA1c of 9% indicates poorly controlled diabetes (normal < 5.7%, poorly controlled > 8%). The patient has acute dental pain (irreversible pulpitis or necrosis). The standard of care is to treat the acute dental emergency (provide pain relief, begin endodontic treatment or extraction) and simultaneously refer the patient to their physician for better glycemic control.
A) Referring without treating leaves the patient in pain and active infection, which will further elevate blood glucose.
B) ER referral is appropriate only for severe systemic complications — not routine endodontic emergencies.
C) Calcium hydroxide temporarily is not the primary emergency treatment; the focus should be emergency pulp treatment.
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