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SGLT2 Inhibitors Dental — ORE Part 1 MCQ

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ModerateHuman Disease & Dental ManagementSGLT2 Inhibitors DentalORE Part 1

A patient taking empagliflozin for type 2 diabetes attends for a dental extraction under local anaesthetic. Which drug-related issue is most relevant to recognise if the patient becomes unwell with nausea, abdominal pain and rapid breathing after reduced oral intake?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Possible ketoacidosis despite a near-normal capillary blood glucose result

Explanation lettering: B = shown as A · A = shown as B · D = shown as C · C = shown as D

A is correct. SGLT2 inhibitors, including empagliflozin, are associated with rare but potentially life-threatening diabetic ketoacidosis (DKA). Its presentation may be atypical: glucose can be only moderately raised or near-normal. Reduced intake, dehydration, acute illness and surgery are recognised precipitating factors, so nausea, abdominal pain and rapid breathing in this setting require urgent medical assessment rather than reassurance from a normal capillary glucose reading. Gingival enlargement is not an established adverse effect of SGLT2 inhibitors. There is no universal interaction with lidocaine, and these drugs do not contraindicate routine dental treatment through direct nephrotoxicity. They improve glycaemic control and do not cure diabetes.

Reference: Electronic Medicines Compendium. Empagliflozin 10 mg and 25 mg film-coated tablets: Summary of Product Characteristics, section 4.4 Ketoacidosis and section 4.8 Undesirable effects. Updated May 2026. https://www.medicines.org.uk/emc/medicine/28973