Endocrine medications

Dental Considerations for Patients Taking Metformin

Routine care — note drug considerations (metformin)

Record of metformin. The points below cover relevant oral side-effects and drug interactions so prescribing and treatment remain safe and non-conflicting.

Emergency vs routine management

If EMERGENCY — what to do

• Check glucose if the patient feels unwell.Ref: American Diabetes Association. Standards of Care in Diabetes — 2024 (Hypoglycaemia; Perioperative care). Diabetes Care 2024;47(Suppl 1)
• Hypoglycaemia (glucose < 4 mmol/L / 70 mg/dL, sweating, confusion): give 15–20 g fast-acting glucose orally, recheck after 15 min; if unconscious give glucagon 1 mg IM and call emergency services.Ref: Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)

If ROUTINE — what to do

• Routine care; ensure the patient has eaten.Ref: American Diabetes Association. Standards of Care in Diabetes — 2024 (Hypoglycaemia; Perioperative care). Diabetes Care 2024;47(Suppl 1)

Clinical precautions

• Risk of hypoglycaemia is low alone; ensure the patient has eaten.
• See the Diabetes condition for glycaemic-control guidance.
• Avoid prescribing drugs that interact; verify any new prescription against the patient's full medication list.

At a glance by procedure

Initial assessment before lab results or timing details are entered.

Procedure	Initial assessment
Examination / radiographs	ROUTINE Routine care — note drug considerations (metformin)
Supragingival scaling / polish	ROUTINE Routine care — note drug considerations (metformin)
Deep scaling / subgingival RSD (subgingival calculus)	ROUTINE Routine care — note drug considerations (metformin)
Root canal treatment	ROUTINE Routine care — note drug considerations (metformin)
Simple extraction (1–3 teeth)	ROUTINE Routine care — note drug considerations (metformin)
Surgical / bony extraction	ROUTINE Routine care — note drug considerations (metformin)
Implant placement	ROUTINE Routine care — note drug considerations (metformin)

Get a patient-specific decision in seconds

Combine all conditions, medications, lab results and the planned procedure — with anaesthetic dose calculation, lab requests and a referral letter PDF.

References

Drug considerations in dentistry (oral side-effects & interactions)
American Diabetes Association. Standards of Care in Diabetes — 2024 (Hypoglycaemia; Perioperative care). Diabetes Care 2024;47(Suppl 1)
Resuscitation Council UK. Medical emergencies and resuscitation — Standards for dental practice, 2020 (updated 2023)

This guide supports — and does not replace — professional clinical judgment. Always consider the individual patient and consult the treating physician when indicated.