Dentists; Treating Patients with a Medical Condition
Understanding a patient's medical condition can have an impact on healing, as well as other problems. Of course, a dentist is not required to diagnose a medical condition such as diabetes. However, it is in the patient's best interest that the provider is aware of any conditions that may affect the patients' treatment.
It is important to be well informed and it may be necessary to do some research on Federal and State rules, as they may affect your decision on providing this service, as well as the scope of your license.
Oral Manifestations from Diabetes
Often times a dentist may be the first provider to see these oral manifestations and by checking the patient's glucose level, be able to educate the patient on controlling their blood sugar.
If a patient has not already been diagnosed, checking their glucose levels may give you insight into their symptoms such as delayed wound healing, dry mouth, or infections.
Indications of diabetes if not properly managed or if the patient is known to have diabetes, it may result in periodontal gum disease, bad breath, bone loss, chewing difficulties, and the loss of teeth.
What is Needed?
- Finger stick with a lancet
- Glucose monitor
- Literature designed for patients from the American Diabetes Association
Prevention and Treatment
Understanding how diabetes can affect the mouth is an important part of dental treatment. It helps identify patients at risk for periodontal disease who may not have been diagnosed, along with those diagnosed, but may have poorly controlled diabetes.
The Dental Practice-Based Research Network (DPBRN) stated in a study that Pre-DM affects about 54 million Americans or 18% of the population. This means that fully one-quarter of Americans have impaired glucose metabolism.
The National Center for Biotechnology Information (NCBI) posted the study done by DPBRN where the goal was to uncover new knowledge in dental offices by conducting a feasibility study of blood glucose screening testing for glucose. According to DPBRN, "The results of the study glucose testing was well-received by patients and practitioners. These results should dispel the belief that glucose testing is time-consuming, expensive, and poorly accepted by patients."
Report D0411 for in-office testing of Hba1c.
Using a glucose meter in the office will provide immediate results of a patient's glucose level. This is reported with the dental code D0412 - for a blood glucose level test in-office using a glucose meter.
For medical claims use 82947 or report 82948 if using a reagent strip.