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Diabetes and Periodontal (Gum) Disease

Content provided by: Better Medicine from Healthgrades

Diabetes that is not properly controlled can lead to periodontal (gum) diseases in both young and old people. Periodontal diseases are infections of the gums and bone that hold the teeth in place.

Diabetes and periodontal diseases:

Because of blood vessel changes that occur with diabetes, the thickened blood vessels can impair the efficiency of the flow of nutrients and removal of wastes from body tissues. This impaired blood flow can weaken the gums and bone, making them more susceptible to infection.

In addition, if diabetes is poorly controlled, higher glucose levels in the mouth fluids will encourage the growth of bacteria that can cause gum disease.


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Medical Reviewer: Medical Reviewer: Gerald W. Smetana, MD Last Annual Review Date: Last Annual Review Date: August 13, 2013 © 2013 Healthgrades, Inc. All rights reserved. May not be reproduced or reprinted without permission from Healthgrades, Inc. Use of this information is governed by the Healthgrades User Agreement.

Indications and Usage for Lantus® (insulin glargine [rDNA origin] injection)

Prescription Lantus® is a long-acting insulin used to treat adults with type 2 diabetes and adults and children (6 years and older) with type 1 diabetes for the control of high blood sugar. It should be taken once a day at the same time each day to lower blood glucose.

Do not use Lantus® to treat diabetic ketoacidosis.

Important Safety Information for Lantus® (insulin glargine [rDNA origin] injection)

Do not take Lantus® if you are allergic to insulin or any of the inactive ingredients in Lantus®.

You must test your blood sugar levels while using insulin, such as Lantus®. Do not make any changes to your dose or type of insulin without talking to your healthcare provider. Any change of insulin should be made cautiously and only under medical supervision.

Do NOT dilute or mix Lantus® with any other insulin or solution. It will not work as intended and you may lose blood sugar control, which could be serious. Lantus® must only be used if the solution is clear and colorless with no particles visible. Do not share needles, insulin pens or syringes with others.

The most common side effect of insulin, including Lantus®, is low blood sugar (hypoglycemia), which may be serious. Some people may experience symptoms such as shaking, sweating, fast heartbeat, and blurred vision. Severe hypoglycemia may be serious and life threatening. It may cause harm to your heart or brain. Other possible side effects may include injection site reactions, including changes in fat tissue at the injection site, and allergic reactions, including itching and rash. In rare cases, some allergic reactions may be life threatening.

Tell your doctor about other medicines and supplements you are taking because they can change the way insulin works. Before starting Lantus®, tell your doctor about all your medical conditions including if you have liver or kidney problems, are pregnant or planning to become pregnant, or are breast-feeding or planning to breast-feed.

Lantus® SoloSTAR® is a disposable prefilled insulin pen. Please talk to your healthcare provider about proper injection technique and follow instructions in the Instruction Leaflet that accompanies the pen.

Please click here or the link below for the full prescribing information for Lantus®

US.GLA.13.12.053 © 2014 sanofi-aventis U.S. LLC, A SANOFI COMPANY


A third factor, smoking, is harmful to oral health even for people without diabetes. However, a person with diabetes who smokes is at a much greater risk for gum disease than a person who does not have diabetes.

Paired with poor oral hygiene, diabetes can lead to gingivitis, the first stage of periodontal disease, or to periodontitis, severe gum disease.

What are the symptoms of periodontal disease?

The following are the most common symptoms of gum disease. However, each individual may experience symptoms differently. Symptoms may include:

  • red, swollen, tender gums

  • bleeding while brushing and/or flossing

  • receding gums

  • loose or separating teeth

  • persistent odorous breath

  • dentures no longer fit

  • pus between the teeth and gums

  • a change in bite and jaw alignment

The symptoms of gum disease may resemble other conditions or medical problems. Consult a dentist or other oral health specialist for a diagnosis.

What are the different types of periodontal disease?

The different types of periodontal disease are often classified by the stage the disease has advanced to at the time of evaluation, including:

  • gingivitis
    With gingivitis, the mildest form of periodontal disease, the gums are likely to become red, swollen, and tender, causing them to bleed easily during daily cleanings and flossing. Treatment by a dentist and proper, consistent care at home help to resolve the problems associated with gingivitis.

  • mild periodontitis
    Untreated gingivitis leads to mild periodontitis. This stage of gum disease shows evidence of the bone around the tooth starting to erode. Prompt medical attention is necessary to prevent further erosion and damage.

  • moderate to advanced periodontitis
    This most advance stage of gum disease shows significant bone and tissue loss surrounding the teeth.

Treatment for periodontal disease:

Specific treatment for periodontal disease will be determined by your dentist based on:

  • your age, overall health, and medical history

  • extent of the disease

  • your tolerance for specific medications, procedures, or therapies

  • expectations for the course of the disease

  • your opinion or preference

Treatment may include any, or a combination of, the following:

  • plaque removal
    Deep cleaning can help remove the plaque and infected tissue in the early stages of the disease, while smoothing the damaged root surfaces of the teeth. The gums can then be reattached to the teeth.

  • medication

  • surgery
    When the disease is advanced, the infected areas under the gums will be cleaned, and the tissues will then be reshaped or replaced. Types of surgeries include:

    • pocket reduction

    • a regeneration procedure

    • a soft-tissue graft

    • crown lengthening

  • dental implants

Diabetes and other oral problems:

Diabetes can also cause other oral problems, including:

  • thrush
    Thrush, a fungal infection of the mouth, occurs more often in persons with diabetes because of high sugar levels in the saliva, as fungus thrives on glucose.

  • dry mouth
    Often a symptom of undetected diabetes, dry mouth means the mouth does not have enough saliva to keep itself wet. Saliva is necessary to help digest food, and prevent infection and tooth decay by controlling bacteria and fungi. Dry mouth can make tasting, chewing, and swallowing food difficult, and can impede speech. In addition, dry mouth can cause mouth infections and tooth decay.

    Although each individual may experience symptoms differently, symptoms of dry mouth may include:

    • sticky, dry mouth

    • dry lips

    • sense of burning in the mouth

    • tough tongue

    • mouth sores or infection

    Always consult your physician for a diagnosis.

    Treatment for dry mouth depends on the cause of the condition. Dry mouth can be caused by medication, disease, cancer treatment, and nerve damage. Some tips to prevent dry mouth symptoms include:

    • Take frequent sips of water or sugarless fluids.

    • Avoid caffeine.

    • Drink fluids during meals.

    • Avoid spicy or salty foods.

    • Avoid tobacco and alcohol.

    • Use a humidifier at night.

    • Chew sugarless gum or sugarless candy.

Reference: Diabetes section on Better Medicine


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