Diabetes, a disease where the body does not produce enough of the blood-sugar–controlling hormone insulin, doesn’t just mess up your blood sugar and internal health. New findings published in Preventing Chronic Disease show folks with the disease also tend to lose their pearly whites as the years go by, the Lighthouse News Daily reports.

For the study, researchers at Duke University reviewed data for more than 37,000 adults who took part in the National Health and Nutrition Survey between 1971 and 2012. Scientists assessed tooth loss trends among white, black and Mexican adults with and without diabetes.

Researchers found that although dental health has drastically improved in the United States over the past 40 years, adults with diabetes today are still twice as likely to lose their teeth than people without the illness.

What’s more, dental health experts estimate that of the nearly half of all American adults who have gum disease, which can lead to tooth loss, most are people living with diabetes.

This study adds to a growing body of evidence linking oral health to diabetes and a number of seemingly unrelated chronic conditions, such as respiratory issues, cardiovascular disease and even cognitive decline.

As a result of the findings, researchers emphasized the importance of regular dental checkups for all populations, especially those with chronic health problems.

For more information about how to cut your diabetes risk, click here.