Dental treatment refused

[Jason 73]

Hi all,
A bit of a weird one, this week I’ve been to the dentist (a new one) for a filling. The dentist asked what my levels were and I said 8.5mmol and showed her the Dexcom reading. She then promptly refused to treat saying that a dentist won’t treat a diabetic with levels over 8mmol and I should see a dietician!
Now, the appointment was 9am, about 1 hour after breakfast, my last hospital Hba1c (8 weeks ago) was 6.4 and the Dexcom is giving a forecasted, over 30 days, reading of 6.2 and looking at both 30 & 60/day averages my TIR (5mmol - 10mmol) is 91%. I told her my control was good, the 8.5mmol was an instant measurement and my bloods fluctuate throughout the day. Still no treatment and still the advice to see a dietician.
Anyone had a similar experience?

 

[AndBreathe]

Hi all,
A bit of a weird one, this week I’ve been to the dentist (a new one) for a filling. The dentist asked what my levels were and I said 8.5mmol and showed her the Dexcom reading. She then promptly refused to treat saying that a dentist won’t treat a diabetic with levels over 8mmol and I should see a dietician!
Now, the appointment was 9am, about 1 hour after breakfast, my last hospital Hba1c (8 weeks ago) was 6.4 and the Dexcom is giving a forecasted, over 30 days, reading of 6.2 and looking at both 30 & 60/day averages my TIR (5mmol - 10mmol) is 91%. I told her my control was good, the 8.5mmol was an instant measurement and my bloods fluctuate throughout the day. Still no treatment and still the advice to see a dietician.
Anyone had a similar experience?

Oh my. Many dentists are happier for those with diabetes running a tine bit higher on the day of treatment, because sometimes the stress increases the chances of a hypo.

Routine (non-emergency) surgery will certainly be declined with an A1c of over 69, due to the increased chanced of infections and slower healing in the aftermath.

It sounds to me like you dentist may be a bit muddled.

I wonder if you could have a telephone appointment to discuss the way forwards.

Good control is important for dental health, as I'm sure you appreciate.

Bewlidered of back of Beyond....

 

[EllieM]

She then promptly refused to treat saying that a dentist won’t treat a diabetic with levels over 8mmol and I should see a dietician!

I wonder if she thought you meant an hba1c of 8.5%. An hba1c of 8% is 64mmol/mol and corresponds to am average blood sugar of 10.1

 

[JMK1954]

I've never heard the like. My first suggestion would be to contact your DSN or hospital clinic for advice. They may have come across this sort of thing before and have a standard letter to cover the situation. Your dentist may be young and relatively inexperienced, so relying on advice intended for surgeons rather than dentists, perhaps.
Alternatively, talk to the reseptionists, ask to see another dentist in the practice, explain the situation and see what they say. There's got to be some sort of misundertanding here. I've had all sorts of successful dental treatment, with the dentists only concerned that I'm not going to drop to hypo levels. A filling shouldn't be causing all this concern.

 

[LittleGreyCat]

Puzzled T2 here.

I can understand a dentist checking current BG level to confirm no major risk of hyper/hypo during treatment.

However the advice to see a dietitian sounds very much like advice appropriate to a T2 with poor control.
Not that your reading indicates poor control.
Someone who didn't pay attention during the 15 minute session on diabetes during training?

 

[david4503]

Sounds to me like a two-way misunderstanding. If dentists ask me about the diabetes they generally want to know if I’m in good control. They may or may not be interested in my A1c specifically. They never ask what my blood sugar is then and there. Here, you showed her your current blood sugar reading and she probably got confused as EllieM suggested. Too much information and I guess, the wrong kind.

 

[Daibell]

When I saw the dentist recently for a filling I wasn't asked at all about the state of my diabetes. May be you ned to find another dentist as this one sounds inflexible and ignorant about diabetes?

 

[EllieM]

Someone who didn't pay attention during the 15 minute session on diabetes during training?

This, plus he/she doesn't know the difference between blood sugar in mmol/L and hba1c in %.
And possibly were trained in the US where hba1c is measured in %.
https://dental.washington.edu/wp-content/media/sp_need_pdfs/Diabetes-Adult.pdf
"An hba1c > 8 indicates poor control."

My top tip for interacting with doctors who are not diabetic specialists - when they ask about your control, give them your hba1c.

 

[Jason 73]

I wonder if she thought you meant an hba1c of 8.5%. An hba1c of 8% is 64mmol/mol and corresponds to am average blood sugar of 10.1

I did wonder that so I clarified with her that she didn’t mean hba1c, (I Simpled it down - “the long range blood test”) and she confirmed no, the immediate finger prick type reading.

 

[zand]

Very many non diabetics would have a reading above 8 one hour after eating.