An asymptomatic patient wants an implant. All other values are controlled, and his chart shows an HbA1c of 7.5% — but that laboratory value is from a year and a half ago. What is the MOST appropriate action?

Correct answer: A. Refer him to his physician for updated laboratory values before proceeding

• A. Correct. HbA1c reflects roughly the preceding 2–3 months of glycemic control — a value 18 months old tells you nothing about the patient today. Before elective surgery with an osseointegration requirement, obtain a CURRENT HbA1c through medical consultation. The age of the value, not the number itself, is the problem here.
• B. Deferring indefinitely is excessive. Routine and urgent care can continue; only the elective surgical procedure waits on updated labs.
• C. The number may or may not be acceptable, but you cannot rely on a stale value. Poorly controlled diabetes impairs osseointegration and wound healing.
• D. Prophylactic antibiotics do not substitute for knowing the patient's actual metabolic status, and are not indicated on the basis of diabetes alone.