The U.S. Centers for Disease Control and Prevention (CDC) estimates that 26 million Americans suffer from diabetes. And another 57 million—about a quarter of U.S. adults—have pre-diabetes, meaning their blood sugar levels are higher than normal, but not yet high enough to be classified as diabetes.

According to the American Diabetes Association, controlling blood sugar levels is a key to preventing many serious complications of diabetes such as heart disease, kidney disease and stroke. Research also suggests a two-way relationship between serious periodontal (gum) disease and diabetes. People with diabetes are more susceptible to severe gum disease, which may have the potential to affect blood glucose control contributing to the progression of diabetes. Additionally, diabetes sufferers tend to develop periodontal disease earlier in life, and more severely. Instead of losing their teeth from gum disease in their 60s, they might begin losing teeth in their mid-40s, and smokers with diabetes are especially at-risk for gum disease and tooth loss.

Unfortunately, studies have found that people with diabetes see their dentist less often than those without the disease. Dentist visits are crucial because oral diseases such as tooth decay and gum disease are often reversible if they are diagnosed early and preventive treatments are delivered. Dentists will also check for other common mouth conditions that afflict people with diabetes, such as dry mouth, ulcers and infections. Mouth conditions may also be a sign that other medical conditions exist elsewhere in the body. Depending on their findings, the dentist might advise patients to seek medical attention.

“Daily brushing and flossing, regular dental check-ups and good blood glucose control are the best defenses against periodontal disease,” says Dr. Bill Kohn DDS, Delta Dental’s Vice President for Dental Science and Policy. “In addition, quitting smoking may be the most important thing that people can do to protect their oral and overall health.”

The good news is that with proper dental hygiene at home and regular visits to the dentist (at least twice annually), there’s no reason people with diabetes should have worse oral health than people without.