Diabetic Patients Should Undergo Dental Check-ups Once a Year: ADA Standard of Care Diabetes 2025 Guidelines

USA: Individuals with diabetes should undergo a dental examination at least once a year the newly released Standard of Care in Diabetes - 2025 American Diabetes Association (ADA) guidelines has recommended.

A new subsection, "Dental Care" was added in this recently released ADA guidelines which includes two recommendations. Recommendation 4.15 states, "People with diabetes should be referred for a dental exam at least once per year", and the second recommendation 4.16 stresses on, "Coordinate efforts between the medical and dental teams to appropriately adjust glucose-lowering medication and treatment plans prior to and in the post–dental procedure period as needed."

The ADA updates its Standards of Care guidelines annually incorporating the latest research and clinical trials, it provides strategies for diagnosing and treating diabetes in youth and adults, preventing type 2 diabetes and related conditions like obesity, and offering care recommendations to improve health outcomes.

Periodontal disease is more severe and prevalent in individuals with diabetes, often linked to higher A1C levels and adverse diabetes outcomes. Evidence suggests that periodontal treatment, such as subgingival instrumentation, can improve glycemic outcomes, as demonstrated in a randomized controlled trial showing better A1C levels (8.3% vs. 7.8%) and reduced inflammatory markers after 12 months of intensive periodontal treatment.

The guidelines recommend early detection of oral health issues, coordination between dental professionals and the diabetes care team, and inclusion of dental history in clinical evaluations. Dental professionals should be informed about patients' glycemic goals, medications, and comorbidities, as elevated A1C levels may impair oral healing. Awareness of hepatic, renal, and pulmonary conditions is vital for appropriate antibiotic and medication dosing.

For patients on insulin, sulfonylureas, or meglitinides, coordination between dental and medical teams is crucial to prevent hypoglycemia during dental procedures. This includes creating prevention plans, adjusting medications, monitoring blood glucose, and treating hypoglycemia as needed. Dental professionals should have access to blood glucose monitors, carbohydrates, and glucagon during procedures to ensure patient safety.

The ADA's Standards of Care in Diabetes—2025 guidelines underscore the significant role of dental care in the comprehensive management of diabetes. By integrating dental health professionals into the diabetes care team, the guidelines aim to address the increased risk and severity of periodontal disease in individuals with diabetes, improve glycemic control through timely interventions, and enhance overall health outcomes.

Reference:

1. American Diabetes Association Professional Practice Committee. 4. Comprehensive Medical Evaluation and Assessment of Comorbidities: Standards of Care in Diabetes-2025. Diabetes Care. 2025 Jan 1;48(Supplement_1):S59-S85. doi: 10.2337/dc25-S004. PMID: 39651988; PMCID: PMC11635044.
2. American Diabetes Association Professional Practice Committee. Summary of revisions: Standards of Care in Diabetes—2025. Diabetes Care 2025;48(Suppl. 1):S6–S13.
3. D’Aiuto F, Gkranias N, Bhowruth D, et al.; TASTE Group. Systemic effects of periodontitis treatment in patients with type 2 diabetes: a 12 month, single-centre, investigator-masked, randomised trial. Lancet Diabetes Endocrinol 2018;6: 954–965.